US Pharm. 2020;45(7/8):4.

Amid surging COVID-19 infection rate in young adults, a new study by researchers at the University of California-San Francisco (UCSF) Benioff Children’s Hospital indicates that youth may not protect people from serious disease. In addition, smoking habits, the study found, trumps asthma and obesity in risk factors.

The study looked at data drawn from a nationally representative sample of approximately 8,400 men and women aged 18 to 25 years and concluded that overall “medical vulnerability” was 33% for males and 30% for females. The impact of smoking surpassed other less common risks, the UCSF researchers reported in their study, which was published in the Journal of Adolescent Health on July 13, 2020.

Data from the CDC, not included in the UCSF study, indicate that while patients over age 65 years are significantly more likely to be hospitalized than younger people, the gap is narrowing. For the week ending April 18, there were 8.7 hospitalizations per 100,000 of the population for the 18-to-29 age bracket, compared with 128.3 per 100,000 of the population for patients over age 65 years. By the week ending June 27, the figures were 34.7 and 306.7 respectively, representing a 299% increase in hospitalizations for young adults, versus a 139% increase in hospitalizations for older adult patients.

The researchers, led by first author Sally Adams, PhD, of the UCSF Division of Adolescent and Young Adult Medicine, determined vulnerability by referencing indicators identified by the CDC. These included heart conditions, diabetes, current asthma, immune conditions (such as lupus, gout, rheumatoid arthritis), liver conditions, obesity, and smoking within the previous 30 days. Additionally, the researchers added e-cigarettes to tobacco and cigar use, which the CDC had included, stating that all three were associated with adverse effects on respiratory and immune function.

“Recent evidence indicates that smoking is associated with a higher likelihood of COVID-19 progression, including increased illness severity, ICU admission, or death,” said Dr. Adams. “Smoking may have significant effects in young adults, who typically have low rates for most chronic diseases.”

The study, which used data from the National Health Interview Survey, found that over the previous 30 days, 10.9% had smoked a cigarette, 4.5% had smoked a cigar product, and 7.2% had smoked an e-cigarette. The number of smokers—1,664 or 19.8%—was higher than the number of people with asthma (8.6%), obesity (3%), and immune disorders (2.4%). Additionally, 1.2% had diabetes, 0.6% had a liver condition, and 0.5% had a heart condition.

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