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Clinical Characteristics and Risk Factors for Mortality in Critical Coronavirus Disease 2019 Patients 50 Years of Age or Younger During the Delta Wave: Comparison With Patients > 50 Years in Korea

BACKGROUND: Numerous patients around the globe are dying from coronavirus disease 2019 (COVID-19). While age is a known risk factor, risk analysis in the young generation is lacking. The present study aimed to evaluate the clinical features and mortality risk factors in younger patients (≤ 50 years)...

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Autores principales: Shi, Hye Jin, Nham, Eliel, Kim, Bomi, Joo, Eun-Jeong, Cheong, Hae Suk, Hong, Shin Hee, Hyun, Miri, Kim, Hyun ah, Jang, Sukbin, Rhee, Ji-Young, Kim, Jungok, Kim, Sungmin, Cho, Hyun Kyu, Wi, Yu Mi, Cheon, Shinhye, Kim, Yeon-Sook, Lim, Seungjin, Seok, Hyeri, Jung, Sook In, Eom, Joong Sik, Peck, Kyong Ran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Academy of Medical Sciences 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9171351/
https://www.ncbi.nlm.nih.gov/pubmed/35668685
http://dx.doi.org/10.3346/jkms.2022.37.e175
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author Shi, Hye Jin
Nham, Eliel
Kim, Bomi
Joo, Eun-Jeong
Cheong, Hae Suk
Hong, Shin Hee
Hyun, Miri
Kim, Hyun ah
Jang, Sukbin
Rhee, Ji-Young
Kim, Jungok
Kim, Sungmin
Cho, Hyun Kyu
Wi, Yu Mi
Cheon, Shinhye
Kim, Yeon-Sook
Lim, Seungjin
Seok, Hyeri
Jung, Sook In
Eom, Joong Sik
Peck, Kyong Ran
author_facet Shi, Hye Jin
Nham, Eliel
Kim, Bomi
Joo, Eun-Jeong
Cheong, Hae Suk
Hong, Shin Hee
Hyun, Miri
Kim, Hyun ah
Jang, Sukbin
Rhee, Ji-Young
Kim, Jungok
Kim, Sungmin
Cho, Hyun Kyu
Wi, Yu Mi
Cheon, Shinhye
Kim, Yeon-Sook
Lim, Seungjin
Seok, Hyeri
Jung, Sook In
Eom, Joong Sik
Peck, Kyong Ran
author_sort Shi, Hye Jin
collection PubMed
description BACKGROUND: Numerous patients around the globe are dying from coronavirus disease 2019 (COVID-19). While age is a known risk factor, risk analysis in the young generation is lacking. The present study aimed to evaluate the clinical features and mortality risk factors in younger patients (≤ 50 years) with a critical case of COVID-19 in comparison with those among older patients (> 50 years) in Korea. METHODS: We analyzed the data of adult patients only in critical condition (requiring high flow nasal cannula oxygen therapy or higher respiratory support) hospitalized with PCR-confirmed COVID-19 at 11 hospitals in Korea from July 1, 2021 to November 30, 2021 when the delta variant was a dominant strain. Patients’ electronic medical records were reviewed to identify clinical characteristics. RESULTS: During the study period, 448 patients were enrolled. One hundred and forty-two were aged 50 years or younger (the younger group), while 306 were above 50 years of age (the older group). The most common pre-existing conditions in the younger group were diabetes mellitus and hypertension, and 69.7% of the patients had a body mass index (BMI) > 25 kg/m(2). Of 142 younger patients, 31 of 142 patients (21.8%, 19 women) did not have these pre-existing conditions. The overall case fatality rate among severity cases was 21.0%, and it differed according to age: 5.6% (n = 8/142) in the younger group, 28.1% in the older group, and 38% in the ≥ 65 years group. Age (odds ratio [OR], 7.902; 95% confidence interval [CI], 2.754–18.181), mechanical ventilation therapy (OR, 17.233; 95% CI, 8.439–35.192), highest creatinine > 1.5 mg/dL (OR, 17.631; 95% CI, 8.321–37.357), and combined blood stream infection (OR, 7.092; 95% CI, 1.061–18.181) were identified as independent predictors of mortality in total patients. Similar patterns were observed in age-specific analyses, but most results were statistically insignificant in multivariate analysis due to the low number of deaths in the younger group. The full vaccination rate was very low among study population (13.6%), and only three patients were fully vaccinated, with none of the patients who died having been fully vaccinated in the younger group. Seven of eight patients who died had a pre-existing condition or were obese (BMI > 25 kg/m(2)), and the one remaining patient died from a secondary infection. CONCLUSION: About 22% of the patients in the young critical group did not have an underlying disease or obesity, but the rate of obesity (BMI > 25 kg/m(2)) was high, with a fatality rate of 5.6%. The full vaccination rate was extremely low compared to the general population of the same age group, showing that non-vaccination has a grave impact on the progression of COVID-19 to a critical condition. The findings of this study highlight the need for measures to prevent critical progression of COVID-19, such as vaccinations and targeting young adults especially having risk factors.
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spelling pubmed-91713512022-06-10 Clinical Characteristics and Risk Factors for Mortality in Critical Coronavirus Disease 2019 Patients 50 Years of Age or Younger During the Delta Wave: Comparison With Patients > 50 Years in Korea Shi, Hye Jin Nham, Eliel Kim, Bomi Joo, Eun-Jeong Cheong, Hae Suk Hong, Shin Hee Hyun, Miri Kim, Hyun ah Jang, Sukbin Rhee, Ji-Young Kim, Jungok Kim, Sungmin Cho, Hyun Kyu Wi, Yu Mi Cheon, Shinhye Kim, Yeon-Sook Lim, Seungjin Seok, Hyeri Jung, Sook In Eom, Joong Sik Peck, Kyong Ran J Korean Med Sci Original Article BACKGROUND: Numerous patients around the globe are dying from coronavirus disease 2019 (COVID-19). While age is a known risk factor, risk analysis in the young generation is lacking. The present study aimed to evaluate the clinical features and mortality risk factors in younger patients (≤ 50 years) with a critical case of COVID-19 in comparison with those among older patients (> 50 years) in Korea. METHODS: We analyzed the data of adult patients only in critical condition (requiring high flow nasal cannula oxygen therapy or higher respiratory support) hospitalized with PCR-confirmed COVID-19 at 11 hospitals in Korea from July 1, 2021 to November 30, 2021 when the delta variant was a dominant strain. Patients’ electronic medical records were reviewed to identify clinical characteristics. RESULTS: During the study period, 448 patients were enrolled. One hundred and forty-two were aged 50 years or younger (the younger group), while 306 were above 50 years of age (the older group). The most common pre-existing conditions in the younger group were diabetes mellitus and hypertension, and 69.7% of the patients had a body mass index (BMI) > 25 kg/m(2). Of 142 younger patients, 31 of 142 patients (21.8%, 19 women) did not have these pre-existing conditions. The overall case fatality rate among severity cases was 21.0%, and it differed according to age: 5.6% (n = 8/142) in the younger group, 28.1% in the older group, and 38% in the ≥ 65 years group. Age (odds ratio [OR], 7.902; 95% confidence interval [CI], 2.754–18.181), mechanical ventilation therapy (OR, 17.233; 95% CI, 8.439–35.192), highest creatinine > 1.5 mg/dL (OR, 17.631; 95% CI, 8.321–37.357), and combined blood stream infection (OR, 7.092; 95% CI, 1.061–18.181) were identified as independent predictors of mortality in total patients. Similar patterns were observed in age-specific analyses, but most results were statistically insignificant in multivariate analysis due to the low number of deaths in the younger group. The full vaccination rate was very low among study population (13.6%), and only three patients were fully vaccinated, with none of the patients who died having been fully vaccinated in the younger group. Seven of eight patients who died had a pre-existing condition or were obese (BMI > 25 kg/m(2)), and the one remaining patient died from a secondary infection. CONCLUSION: About 22% of the patients in the young critical group did not have an underlying disease or obesity, but the rate of obesity (BMI > 25 kg/m(2)) was high, with a fatality rate of 5.6%. The full vaccination rate was extremely low compared to the general population of the same age group, showing that non-vaccination has a grave impact on the progression of COVID-19 to a critical condition. The findings of this study highlight the need for measures to prevent critical progression of COVID-19, such as vaccinations and targeting young adults especially having risk factors. The Korean Academy of Medical Sciences 2022-05-23 /pmc/articles/PMC9171351/ /pubmed/35668685 http://dx.doi.org/10.3346/jkms.2022.37.e175 Text en © 2022 The Korean Academy of Medical Sciences. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Shi, Hye Jin
Nham, Eliel
Kim, Bomi
Joo, Eun-Jeong
Cheong, Hae Suk
Hong, Shin Hee
Hyun, Miri
Kim, Hyun ah
Jang, Sukbin
Rhee, Ji-Young
Kim, Jungok
Kim, Sungmin
Cho, Hyun Kyu
Wi, Yu Mi
Cheon, Shinhye
Kim, Yeon-Sook
Lim, Seungjin
Seok, Hyeri
Jung, Sook In
Eom, Joong Sik
Peck, Kyong Ran
Clinical Characteristics and Risk Factors for Mortality in Critical Coronavirus Disease 2019 Patients 50 Years of Age or Younger During the Delta Wave: Comparison With Patients > 50 Years in Korea
title Clinical Characteristics and Risk Factors for Mortality in Critical Coronavirus Disease 2019 Patients 50 Years of Age or Younger During the Delta Wave: Comparison With Patients > 50 Years in Korea
title_full Clinical Characteristics and Risk Factors for Mortality in Critical Coronavirus Disease 2019 Patients 50 Years of Age or Younger During the Delta Wave: Comparison With Patients > 50 Years in Korea
title_fullStr Clinical Characteristics and Risk Factors for Mortality in Critical Coronavirus Disease 2019 Patients 50 Years of Age or Younger During the Delta Wave: Comparison With Patients > 50 Years in Korea
title_full_unstemmed Clinical Characteristics and Risk Factors for Mortality in Critical Coronavirus Disease 2019 Patients 50 Years of Age or Younger During the Delta Wave: Comparison With Patients > 50 Years in Korea
title_short Clinical Characteristics and Risk Factors for Mortality in Critical Coronavirus Disease 2019 Patients 50 Years of Age or Younger During the Delta Wave: Comparison With Patients > 50 Years in Korea
title_sort clinical characteristics and risk factors for mortality in critical coronavirus disease 2019 patients 50 years of age or younger during the delta wave: comparison with patients > 50 years in korea
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9171351/
https://www.ncbi.nlm.nih.gov/pubmed/35668685
http://dx.doi.org/10.3346/jkms.2022.37.e175
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