Logan Reid
The COVID-19 pandemic has resulted in a large number of hospitalizations worldwide. In the US, more than 11 million cases have been recorded, with over 500 known hospitalizations. Notably, the virus has hospitalized many young adults, indicating that COVID-19 prevention is not just for older people. Among the over 500 hospitalizations, 18% were between 45 and 54 years old, while 20% were aged 20 to 44 years. Furthermore, American Indian or Alaska Native people have been hospitalized at a rate 4.1 times higher than that of white people, while Black people have been hospitalized at 3.9 times the rate of white people. These statistics emphasize that COVID-19 can severely impact people of all ages and ethnicities, and social distancing is recommended for everyone to slow the spread of the virus.
| Characteristics | Values |
|---|---|
| Number of people hospitalized in the US | 500+ |
| Percentage of hospitalized patients aged 45-54 | 18% |
| Percentage of hospitalized patients aged 20-44 | 20% |
| Hospitalization rate of American Indian/Alaska Native people compared to white people | 4.1 times higher |
| Hospitalization rate of Black people compared to white people | 3.9 times higher |
| Surveillance area covered by COVID-NET | 185 counties and county equivalents in 13 states |
| Population covered by COVID-NET | More than 34 million people (estimated 10% of the US population) |
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What You'll Learn
- Racial disparities: American Indian/Alaska Native and Black people hospitalized at higher rates than white people
- Age range: COVID-19 hospitalizations occur in people of all ages, including young adults
- Clinical characteristics: hospitalization reasons vary, including underlying conditions
- ICU admissions: some coronavirus patients require intensive care
- Discharge outcomes: patients are discharged from the hospital or, sadly, pass away
Racial disparities: American Indian/Alaska Native and Black people hospitalized at higher rates than white people
The COVID-19 pandemic has disproportionately impacted people from some racial and ethnic minority groups in the US. The pandemic has likely exacerbated the gaps in wealth, employment, housing, and access to healthcare. These are the social determinants of health that caused the disparities in the first place.
Black, Latinx, and American Indian/Alaska Native (AIAN) persons have been hospitalized and died at a higher rate than White persons since the start of the pandemic. In a study of 35 states, the average Black persons to White persons crude death rate disparity ratio was 1.6. After adjusting for age and state, the disparity ratio grew to 2.7. AIAN persons have the highest incident cases and deaths per 100,000 populations for most of the pandemic. Early data also shows that hospitalization and mortality rates for Black, Latinx, and AIAN children are higher than for White children.
American Indians/Alaska Natives have long faced health disparities in the United States. For instance, the infant mortality rate for Native Americans and Alaska Natives is 60% higher than for White people. The rate of suicide is highest for male American Indians/Alaska Natives, and they are also more likely to die from unintentional injuries. The rates of diabetes as an underlying cause of death are 2.5 to 3.5 times higher for Native Americans than for Whites aged 20 and older.
The COVID-19 pandemic has highlighted the need to address disparities in health and healthcare access for racial and ethnic minorities. While data limitations, particularly for smaller population groups, hamper the ability to get a complete picture, efforts to improve data collection and reporting by race and ethnicity will help identify and address disparities.
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Age range: COVID-19 hospitalizations occur in people of all ages, including young adults
COVID-19 has resulted in hospitalizations across all age groups, including young adults and children. While older adults are more vulnerable to severe illness and death from COVID-19, younger people are not immune to the virus. Many young adults and children have been hospitalized due to COVID-19, and some have even experienced long-term effects from the infection.
During the early stages of the pandemic, media reports emerged of young people in multiple countries disregarding social distancing guidelines. This prompted the World Health Organization (WHO) to issue a warning against complacency. WHO Director-General Tedros Adhanom Ghebreyesus emphasized that "although older people are hardest hit, younger people are not spared." He added that COVID-19 could put young people in the hospital for weeks and even lead to death.
Data from the US Centers for Disease Control and Prevention (CDC) supports this assertion. Among the more than 500 people hospitalized in the US due to COVID-19, 18% were aged 45-54, and notably, 20% were in the 20-44 age bracket. This data highlights that younger adults comprised a significant proportion of COVID-19 hospitalizations.
Furthermore, COVID-19 hospitalization rates for children and young adults reached record highs in 2021. CDC data indicated that more children and individuals under 50 were hospitalized with COVID-19 than at any other point during the pandemic. This trend underscores the impact of the virus on younger age groups.
Long COVID, characterized by chronic symptoms and conditions that persist or emerge over time, can affect people of all ages, including children. Vaccination is the most effective strategy to prevent Long COVID, and it is recommended for all eligible age groups to reduce the risk of severe illness and hospitalization.
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Clinical characteristics: hospitalization reasons vary, including underlying conditions
COVID-19 has resulted in the hospitalisation of people of all ages, including younger adults. Clinical characteristics of hospitalised patients vary, with underlying conditions playing a significant role in the reasons for hospitalisation.
Underlying health conditions are a critical factor in COVID-19 hospitalisations. Adults aged 65 and older, as well as those with chronic health issues such as diabetes and heart disease, are at the highest risk of severe illness and hospitalisation. The presence of underlying medical conditions influences the progression of the disease and the need for medical interventions.
Patients with COVID-19 infections present a range of symptoms upon hospitalisation. Geriatrician June McKoy observes that some patients experience respiratory issues and require treatment for low oxygen levels. Others exhibit gastrointestinal symptoms such as loss of appetite and diarrhoea, and GI issues. Additionally, dizziness, confusion, or a sudden change in mental status is prevalent, especially among older adults, and may be indicative of decreasing oxygen levels affecting brain function.
COVID-19 hospitalisations are monitored by the COVID-19 Hospitalisation Surveillance Network (COVID-NET), which is part of the Respiratory Virus Hospitalisation Surveillance Network (RESP-NET). COVID-NET collects demographic and clinical data, including underlying conditions, to understand hospitalisation trends and identify high-risk individuals. This information is vital for public health responses to outbreaks and estimating the disease burden.
The clinical characteristics of hospitalised patients with COVID-19 vary, and underlying conditions are a significant factor in their hospitalisation. The disease can lead to severe illness, especially in high-risk individuals, requiring medical interventions such as mechanical ventilation in intensive care units. The surveillance networks provide valuable insights into hospitalisation trends and patient demographics, aiding in the understanding and management of the disease.
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ICU admissions: some coronavirus patients require intensive care
While the vast majority of patients with COVID-19 do not require intensive care, it is still a necessity for a notable number of people. A report from the US Centers for Disease Control and Prevention highlights that people of all ages are being hospitalized by the virus, with 18% aged 45-54 and 20% aged 20-44. This is supported by the World Health Organization (WHO), which has warned against complacency, stating that "younger people are not spared".
ICU admissions are often required when patients face a significant risk of deterioration, and respiratory failure can occur late in the disease. In one study, 245 subjects were examined, with a mean age of 59.0 ± 14.2 years, 61.2% of whom were male. Of these, 19.6% to 20% were transferred to the ICU, with a median time to transfer of 2.5 days. More than half (54.2%) of patients were moved to intensive care within 48 hours of admission, while 33.3% were not transferred until hospital day 4 or later. The main reason for transfer to intensive care was progressive respiratory failure (79.2%).
The high prevalence of Acute Respiratory Distress Syndrome (ARDS) in ICU patients has placed a considerable burden on acute care hospitals and intensive care units (ICUs). Limitations in ICU resources have contributed to the logic of "flattening the curve", with a better understanding of who might require ICU admission facilitating disease modelling and public health policy.
The need for mechanical ventilation (MV) is also common in ICU patients, with 66.6% of those transferred requiring it. Of these, 12 required immediate intubation, while 20 failed efforts with non-invasive ventilation (NIV) and/or high-flow oxygen. In some cases, a tracheostomy tube may be considered after two weeks of ventilation to allow more time for lung recovery and to avoid damage to the vocal cords.
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Discharge outcomes: patients are discharged from the hospital or, sadly, pass away
The COVID-19 Hospitalization Surveillance Network (COVID-NET) tracks COVID-19-associated hospitalizations in the US, monitoring trends and comparisons in different demographic groups. Hospitalization rates can be viewed weekly, monthly, or cumulatively.
A study of 5279 patients with laboratory-confirmed COVID-19 in New York City between March and April 2020 found that 51.9% were admitted to the hospital, of whom 69.5% were discharged alive without hospice care and 24.3% were discharged to hospice care or died. Age and comorbidities were found to be strong predictors of hospital admission, and impairment of oxygen on admission and markers of inflammation were associated with critical illness and mortality.
In a Tunisian intensive care unit, a longitudinal study was conducted on 319 COVID-19 patients with a mean age of 62 years. The average length of stay was 9 days, and 32% of patients had at least one cross-infection. Cross-infections impact patient prognosis, and patients with severe COVID-19 are more likely to have poor outcomes.
A study in Iran evaluated the psychological and quality-of-life complications of 283 COVID-19 patients three months after hospital discharge. The mean age was 53.65 years, with 68% experiencing a severe disease course. The main symptoms at 12 weeks after discharge were fatigue, cough, shortness of breath, and chest pain.
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Frequently asked questions
More than 91,000 people have been hospitalized with coronavirus in the US, which was the highest number recorded during the pandemic.
318 people were hospitalized due to coronavirus in Utah, with 5,395 total hospitalizations in the state.
Yes, according to a study, people hospitalized with severe COVID-19 have an increased risk of death and health complications for at least two and a half years after their initial illness.
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