More young adults in the city of New York are hospitalized with infections COVID-19 at rates surprisingly high, said doctors and other health care workers who treat them, which undermines previous assumptions about who is at greatest risk from the novel coronavirus.
New York has more confirmed cases than in any other place in the united States, and approximately one out of every 5 hospitalizations are occurring in people under the age of 44 yearsaccording to data published by the department of health of the city. At the global level, according to the World Health Organization, there have been cases of moderate to severe in the 10 percent to 15 percent of adults under the age of 50 years.
Friday, at Mount Sinai Hospital Morningside of Manhattan, a male patient of 32 years old, previously healthy, went to the doctor Kaedrea Jackson and asked: “am I going to die?”
The young man, who had no underlying medical conditions, had difficulty breathing with fever and his oxygen levels decreased rapidly. He had gone to the emergency department of the hospital four days before, but told her to go home, drink water, take Tylenol and isolate. Now he had returned and his condition was deteriorating. “The level of fear in their eyes caught my attention,” recalled Jackson, a doctor of medical emergencies, in an interview Tuesday. “I was extremely scared. And he was very young.
For months, the message from the authorities had been that the elderly were at the greatest risk. It is so believed that the health officials decided to punish the people of between 20 and 30 years to stay at home, not to protect, but to avoid transmitting the disease to the populations of older age. That changed in mid-march, when a high officer of health, the White House warned that young people in Italy and France they were falling sick. Now, the trend has appeared in the united States.
“Many patients do not fit the image that we were told from China or Italy. This is not only elderly patients; it is anyone,” Jackson said. A confidential report on intelligence of the united States has raised doubts about the reports from China about the outbreak, including the cases of underestimation, Bloomberg News reported on Wednesday.
Jackson estimated that up to 20 per cent of the confirmed cases in the hospital have been under the age of 50 years. Many doctors are younger in their 30 years are seeing healthy patients of age admitted in the hospital and in need of a respirator.
“People are afraid. Are patients of that you think: This should not be sucediéndote. You’re so young. Why is this happening?”
The New York governor, Andrew Cuomo, said that too many young people have not received the message that may be infected.
“You can still see too many situations with too much density on the part of young people,” Cuomo said in his press conference daily Wednesday. “You can get it, and are putting their lives at risk. This can kill the young, rare circumstances, but you can.”
The lack of evidence generalized to the virus in the united States has made it difficult for health officials to know which groups are most at risk. But doctors and other health workers who spoke with Bloomberg described a surprising number of younger patients in need of care to save lives.
“It’s about young people, previously healthy,” said Eric Wei, a doctor of the emergency room and director of quality assurance NYC Health + Hospitals, the public hospital system of the city. “It seems like they have the flu. In a matter of hours, they need oxygen. In a few hours need a fan”.
In the Langone Medical Center Health, University of New York with a view of the East River in Manhattan, dozens of patients in intensive care the last week were less than 50 years, according to a worker who was providing direct medical care. A handful was approximately 20 years old, and one had only 7 years. The hospital refused to provide exact numbers of patients COVID-19, details about their ages or if they had conditions underlying health conditions, citing patient privacy.
In China, which was attacked first by the virus, only 4.3 percent of patients 40 to 49 years of age were hospitalized after developing COVID-19, according to a report published in the journal Lancet Infectious Diseases. It was even lower for younger people, since only 1 percent of people between 20 years and 3.4 percent of people between the ages of 30 and 39 years require hospitalization, according to the report.
Those gaps may be formed by differences in demographics, the proportion of people with preexisting conditions or practices, or resources of different medical. Italy, for example, has one of the oldest populations of Europe and the people of 80 years and older died at a rate of around 20 percent. In China, the mortality rate for the same age group was 15 per cent.
“These cases in people young and middle age are amazing,” said Paul Sax, clinical director of infectious diseases at the Brigham and Women’s Hospital in Boston. “That’s not how it was perceived originally from far away. Definitely, there are people who are surprised that it is a serious infection in this group, people who were previously completely healthy and exercising and they were good.”
In New York, 77 percent of the 914 patients who died had a medical condition such as diabetes, lung disease, heart disease or asthma, according to the department of health of the city. Only 1.5 percent were healthy, and another 20 per cent of the cases are still under review. A more comprehensive analysis conducted by the Centers for disease Control and Prevention (CDC) of the united States found a similar trend: that three-quarters of americans who ended up in the ICU due to COVID-19 had one or more underlying health problems. Few people with such problems can recover without hospitalization, said the CDC.
Two-thirds of the population of the united States are overweight or obese, factors that increase the risk of COVID-19. Almost half of adults have high blood pressure. And one out of every eight americans has not visited a doctor in the last year, which means that some may have health problems and not know it.
Experts are seeing the same pattern emerging in other places of the united States as they grow older outbreaks. In Philadelphia, 56 percent of the confirmed cases of COVID-19 are under the age of 40 years. A teenager lost his life in Los Angeles, a 12 year old child was intubated in Seattle, a baby was infected in Delaware and a baby of one year died in Chicago.
For patients seen by the infection with the help of a fan, may have long-term health problems, said Ross McKinney, Jr., scientific director of the Association of American Medical Colleges. Even for younger patients, physicians have to use fans set to high pressure, pumping high levels of oxygen.
“Many will end up with lungs damaged and, thereafter, may be limited in the future”, he said. “Any respiratory illness the sick, because you don’t have reservations, and things like running cross country or doing a 5 km run might be outside. You may not be able to be as active because their lungs no longer have the ability”.
The flood of young patients has been difficult for physicians, Jackson said.
“It is difficult to lose someone,” he said. But when doctors have to intubate patients of 20, 30 and 40 years, that weighs heavily. “Are young people, those with a full life ahead of you that not have medical problems. They are the ones that are hard to forget.”