Predictors of worse prognosis in young adults hospitalized with COVID-19 pneumonia: a multi-center Italian study (COVID-UNDER50)

Abstract

Predictors of worse prognosis in young adults hospitalized with COVID-19 pneumonia: a multi-center Italian study (COVID-UNDER50)

Background: Obesity as well as metabolic and cardiovascular comorbidities are established, significant predictors of worse prognosis in overall COVID-19population, but limited information are available on their specific roles in young adults (aged ≤ 50 years). The main objectives of the present Italian multi-center study were to describe clinical characteristics, and role of selected prognostic predictors in a large cohort of young hospitalized patients with COVID-19 pneumonia.

Methods: Nine Pulmonology Units, across North and Centre of Italy, were involved. Demographic and clinical characteristics as well as radiological features were registered for all cases. Comorbidity were classified according to their known or potential association with COVID-19.

Results: 263 subjects were included. The prevalence of obesity was 25.9%, mechanical ventilation (MV) was needed in 27.7%, and 28 in-hospital deaths occurred (10.6%). Obesity and older age were the only significant predictors for MV in a full model adjusted for comorbidities and markers of severity. Comorbidities, such as hypertension, diabetes and asthma, were associated with a 6-times higher mortality risk (p=0.001) regardless of age, body mass index, and MV.

Conclusions: Obesity in young adults is, per se, a strong, independent, predictor of a more complicated COVID-19, without, however, influencing in-hospital mortality. On the other hand, selected comorbidities, mainly hypertension, diabetes and asthma, significantly impact survival even in a young population.