Age Distribution of Coronavirus Disease 2019, a Review of Laboratory Data from a Regional Health System

BACKGROUND: Since the coronavirus disease 2019 (COVID-19) pandemic began in early 2020, data has shown that the risk for admission and death among younger patients is low despite many positive tests in this age group. Between June-August 2020, persons aged 20-29 years accounted for >20% of total cases yet mortality rate is close to 0%. As community transmission of COVID-19 advances, our objective is to understand the age trends for COVID-19 across a regional health system. METHODS: A retrospective analysis of COVID-19 test results from a regional health system laboratory from March 16th - November 15th, 2020 was conducted. All COVID-19 inpatient admissions and mortality data for the same time was included. Positivity rate, proportion of positive tests and hospitalization, along with mortality rates were calculated. RESULTS: A total of 484,824 results were reviewed of which 21,109 was positive (4.4%). Individuals under the age of thirty accounted for 39% of positive tests whereas 20% was from those sixty and above. Among those hospitalized, 11% were < 30 years and 60% were ≥60 years, approximately six times more hospitalization for patients of older age (proportion p-value < 0.001). Inpatient mortality rate for patients < 30 years was 0% versus 13% for patients ≥60 years (p-value < 0.001). The highest mortality rate (28%) was among patients ≥90 years. Overall, 92% of inpatient deaths occurred in patients sixty and above. CONCLUSIONS: This study found that many young individuals test positive for COVID-19; however, majority do not require hospitalization. Furthermore, no deaths were observed, indicating that all recovered. Unfortunately, older patients did not behold the same outcome, highlighting that high number of positive tests observed among younger patients do not relate directly to admission and mortality. This indicates the gravity of strict adherence to prevention strategies and behaviors in the community to safeguard those at higher risk for hospitalization and associated mortality.