RT Journal Article SR Electronic T1 COVID-19 in young and middle aged adults. Predictors of poor evolution and clinical differences JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP OA88 DO 10.1183/13993003.congress-2021.OA88 VO 58 IS suppl 65 A1 Eva Tabernero Huguet A1 Luis Alberto Ruiz Iturriaga A1 Leire Serrano Fernandez A1 Pedro Pablo España Yandiola A1 Raul Mendez A1 Borja Santos Zorrozua A1 Ane Uranga Echeverria A1 Paula Gonzalez Jimenez A1 Patricia Garcia Hontoria A1 Rosario Menendez Villanueva A1 Rafael Zalacain Jorge YR 2021 UL http://erj.ersjournals.com/content/58/suppl_65/OA88.abstract AB Young and middle-aged adults are the largest group of patients infected with SARS-CoV-2. Some of them develop severe diseasePurpose: To investigate clinical aspects in adults aged 18-65 years hospitalized for COVID-19  and identify risks factors for poor evolution. As secondary aims we intend to assess potential differences with the disease in elderly patients and the suitability of the commonly used community acquired pneumonia prognostic scales in this population.Methods: multicentric, prospective registry of consecutive patients hospitalized for COVID-19 pneumonia aged 18-65 years in March-May 2020. A composite outcome of “poor evolution” including admission to ICU and/or use of noninvasive ventilation, CPAP, high flow nasal cannula oxygen or death was developed.Results: We identified 513 patients < 65 years, from a cohort of 993 patients. 102 patients had poor evolution (19.8%) and mortality was 3.9%. 78%-55% of patients with poor evolution were in CURB and PSI low risk groups respectively. Main results are shown Figure 1.Conclusion: COVID-19 has significant morbidity in younger patients. Heart disease is a relevant risk factor, while anosmia and chest pain are protective. Hypoxemia, LDH and lymphocyte count are predictors of poor evolution. CURB and PSI scores are not suitable to decide outpatient treatment in this populationFootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, OA88.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).