Tripathi Sandeep, Sayed Imran A, Dapul Heda, McGarvey Jeremy S, Bandy Jennifer A, Boman Karen, Kumar Vishakha K, Bansal Vikas, Retford Lynn, Cheruku Sreekanth, Kaufman Margit, Heavner Smith F, Danesh Valerie C, St Hill Catherine A, Khanna Ashish K, Bhalala Utpal, Kashyap Rahul, Gajic Ognjen, Walkey Allan J, Gist Katja M
Department of Pediatrics, OSF Saint Francis Medical Centre/University of Illinois College of Medicine, Peoria, IL.
University of Colorado Anschutz Medical Campus, Department of Pediatrics, Children's Hospital Colorado, Aurora, CO.
Crit Care Explor. 2021 Aug 20;3(8):e0514. doi: 10.1097/CCE.0000000000000514. eCollection 2021 Aug.
Even with its proclivity for older age, coronavirus disease 2019 has been shown to affect all age groups. However, there remains a lack of research focused primarily on the young adult population.
To describe the epidemiology and outcomes of coronavirus disease 2019 and identify the risk factors associated with critical illness and mortality in hospitalized young adults.
A retrospective cohort study of the Society of Critical Care Medicine's Viral Infection and Respiratory Illness Universal Study registry. Patients 18-40 years old, hospitalized from coronavirus disease 2019 from March 2020 to April 2021, were included in the analysis.
Critical illness was defined as a composite of mortality and 21 predefined interventions and complications. Multivariable logistic regression was used to assess associations with critical illness and mortality.
Data from 4,005 patients (152 centers, 19 countries, 18.6% non-U.S. patients) were analyzed. The median age was 32 years (interquartile range, 27-37 yr); 51% were female, 29.4% Hispanic, and 42.9% had obesity. Most patients (63.2%) had comorbidities, the most common being hypertension (14.5%) and diabetes (13.7%). Hospital and ICU mortality were 3.2% (129/4,005) and 8.3% (109/1,313), respectively. Critical illness occurred in 25% ( = 996), and 34.3% ( = 1,376) were admitted to the ICU. Older age ( = 0.03), male sex (adjusted odds ratio, 1.83 [95% CI, 1.2-2.6]), and obesity (adjusted odds ratio, 1.6 [95% CI, 1.1-2.4]) were associated with hospital mortality. In addition to the above factors, the presence of any comorbidity was associated with critical illness from coronavirus disease 2019. Multiple sensitivity analyses, including analysis with U.S. patients only and patients admitted to high-volume sites, showed similar risk factors.
Among hospitalized young adults, obese males with comorbidities are at higher risk of developing critical illness or dying from coronavirus disease 2019.
尽管2019冠状病毒病更倾向于影响老年人，但已证实它会影响所有年龄组。然而，仍然缺乏主要针对年轻成年人群体的研究。
描述2019冠状病毒病的流行病学和结局，并确定住院年轻成年人中与危重症和死亡相关的危险因素。
设计、地点和参与者：对危重病医学学会的病毒感染和呼吸道疾病通用研究登记处进行的一项回顾性队列研究。纳入分析的患者为2020年3月至2021年4月因2019冠状病毒病住院的18至40岁患者。
危重症定义为死亡以及21项预先定义的干预措施和并发症的综合情况。采用多变量逻辑回归分析来评估与危重症和死亡的相关性。
分析了来自4005例患者（152个中心，19个国家，18.6%为非美国患者）的数据。中位年龄为32岁（四分位间距，27 - 37岁）；51%为女性，29.4%为西班牙裔，42.9%患有肥胖症。大多数患者（63.2%）有合并症，最常见 的是高血压（14.5%）和糖尿病（13.7%）。医院死亡率和重症监护病房（ICU）死亡率分别为3.2%（129/4005）和8.3%（109/1313）。25%（n = 996）发生了危重症，34.3%（n = 1376）被收入ICU。年龄较大（P = 0.03）、男性（调整后的优势比，1.83[95%置信区间，1.2 - 2.6]）和肥胖（调整后的优势比，1.6[95%置信区间，1.1 - 2.4]）与医院死亡率相关。除上述因素外，任何合并症的存在都与2019冠状病毒病危重症相关。多项敏感性分析，包括仅对美国患者以及对入住大量患者的医院的患者进行分析，均显示了类似的危险因素。
在住院的年轻成年人中，患有合并症的肥胖男性发生2019冠状病毒病危重症或死亡的风险更高。
