Predictors of Worse Prognosis in Young and Middle-Aged Adults Hospitalized with COVID-19 Pneumonia: A Multi-Center Italian Study (COVID-UNDER50)

• Published in: Journal of clinical medicine 2021-03, Vol.10 (6), p.1218
• Main Authors: Bonifazi, Martina, Mei, Federico, Skrami, Edlira, Latini, Lara Letizia, Amico, Donatella, Balestro, Elisabetta, Bini, Francesco, Bonifazi, Floriano, Caminati, Antonella, Candoli, Piero, Cinti, Saverio, Contucci, Susanna, Di Marco Berardino, Alessandro, Harari, Sergio, Levi, Guido, Lococo, Sara, Menditto, Vincenzo, Marchetti, Giampietro, Piciucchi, Sara, Poletti, Venerino, Ravaglia, Claudia, Saetta, Marina, Svegliati-Baroni, Gianluca, Tomassetti, Sara, Tamburrini, Mario, Zanforlin, Alessandro, Zuccon, Umberto, Zuccatosta, Lina, Gasparini, Stefano, Carle, Flavia
• Format: Article
• Language: English
• Subjects: Asthma; Body mass index; Cardiovascular disease; Clinical medicine; Comorbidity; Coronaviruses; COVID-19; Diabetes; Fatalities; Hospitalization; Hypertension; Infections; Laboratories; Medical prognosis; Middle age; Obesity; Patients; Pneumonia; Regression analysis; Severe acute respiratory syndrome coronavirus 2; Variables
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm10061218

Obesity as well as metabolic and cardiovascular comorbidities are established, significant predictors of worse prognosis in the overall COVID-19 population, but limited information is available on their roles in young and middle-aged adults (aged ≤ 50 years). The main objectives of the present Italian multi-center study were to describe clinical characteristics and role of selected prognostic predictors in a large cohort of young and middle-aged hospitalized patients. Nine pulmonology units, across north and center of Italy, were involved in this retrospective study. Comorbidities were classified according to their known or potential association with COVID-19. A total of 263 subjects were included. The prevalence of obesity was 25.9%, mechanical ventilation (MV) was needed in 27.7%, and 28 in-hospital deaths occurred (10.6%). Obesity and older age were the only independent, significant predictors for MV. Comorbidities, such as hypertension, diabetes, asthma, and increased D-dimer levels were significantly associated with higher mortality risk, regardless of age, body mass index, and MV. Obesity in young and middle-aged adults is a strong predictor of a more complicated COVID-19, without, however, evidence of a significant effect on in-hospital mortality. Selected comorbidities, including hypertension, diabetes and asthma, significantly impact survival even in a younger population, suggesting the need for prompt recognition of these conditions.