Complications in Hospitalized COVID-19 Patients More Common, Affect Younger Population

In a large observational study from the United Kingdom, investigators reported that 1 out of every 2 hospitalized patients developed one or more health complications. In their findings, 36,367 of 73,197 saw complications during their hospitalization. In addition, patients between 19-39 years of age made up 64% of the complications. Specifically, 27% of patients aged 19-29 year old, and 37% of patients aged 30-39 experienced a complication.

This age-related discovery offers a contrarian view of the public perception that COVID-19 mostly impacts seniors and those with underlying conditions.  

“This work contradicts current narratives that COVID-19 is only dangerous in people with existing comorbidities and the elderly,” Chief Investigator and joint senior author of the study, Professor Calum Semple, University of Liverpool, UK, said. “Dispelling and contributing to the scientific debate around such narratives has become increasingly important. Disease severity at admission is a predictor of complications even in younger adults, so prevention of complications requires a primary prevention strategy, meaning vaccination.”

And with the majority of patients being admitted to hospitals being people who are unvaccinated, and the Delta variant proving to be highly transmissible, younger people who have chosen not to get the vaccine, should be aware of these findings.

The findings were published today in The Lancet.

The authors reported the most common complications included renal, complex respiratory, and systemic complications; however it is important to note patients did experience others related to cardiovascular, neurological, gastrointestinal and liver health conditions.

“These complications could affect any organ, but particularly the kidney, heart and lungs,” Joint senior author Professor Ewen Harrison from the University of Edinburgh, UK, says Those with complications had poorer health on discharge from hospital, and some will have long-term consequences. We now have a more detailed understanding of COVID-19 and the risks posed, even to younger otherwise healthy people.”

The study looked at cases between January 17 and August 4, 2020 before vaccines were widely available, and new variants of the virus had not arisen. People of white, South Asian, and East Asian ethnicities had similar rates of complications, but rates were highest in in Black patients vs 49% [26,431 of 53,780] in white patients.

Following hospitalization, 27% (13,309 of 50,105) of patients were less able to look after themselves than before COVID-19, and this was more common with older age, being male, and in people who received critical care. The association between having a complication and worse ability for self-care remained irrespective of age, sex, socioeconomic status, and which hospital someone received treatment in. Neurological complications were associated with the biggest impact on ability for self-care.

The most common complications were renal (affecting almost one in four people, 24%, 17,752), respiratory (affecting around one in five people, 18%, 13,486), and systemic (affecting one in six, 16%, 11,895). However, cardiovascular complications were reported in around one in eight participants (12%, 8,973), and neurological (less than one in 20, 4%, 3,115), and gastrointestinal or liver (less than 1%, 7,901) complications were also reported. Specifically, acute kidney injury, probable acute respiratory distress syndrome, liver injury, anemia, and cardiac arrhythmia were the most common complications.