In young US adults, smoking boosts predicted vulnerability for severe COVID-19

  • Adams SH & et al
  • J Adolesc Health
  • 14 Jul 2020

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Almost one-third of US adults ages 18-25 years have predicted medical vulnerability to severe COVID-19 illness.
  • Smoking (cigarettes, cigars, e-cigarettes) substantially adds to the predicted risk.

Why this matters

  • Risk reduction efforts might best be targeted to prevention of conventional and e-cigarette use, improved diet, and other vulnerabilities in young adults.

Key results

  • Data were analyzed for 8405 young adults (50.4% male, 49.6% female).
  • Demographics: 55% white, 13% Black, 22% Hispanic, 6% Asian, 4% other.
  • Overall medical vulnerability: 31.5%.
    • By sex: 29.7% among females vs 33.3% among males (P<.01>
  • Vulnerability rate by insurance status:
    • Fully insured: 30%.
    • Partial-year uninsured: 40% (P<.001 vs fully>
    • Full-year uninsured: 37% (P<.01 vs fully>
  • Vulnerability rate for nonsmokers: 16.1% (1101/6741).
    • By sex: 18.6% among females vs 13.4% among males (P<.001>
  • Highest estimated rates for individual factors:
    • Past 30-day smoking: 10.9%. 
    • Current asthma: 8.6%. 
    • Past 30-day e-cigarette use: 7.2%. 
    • Past 30-day cigar use: 4.5%.
  • Across all analyses, whites had higher predicted vulnerabilities compared with Blacks, Hispanics, and Asians, suggesting a role for factors other than medical vulnerability.

Study design

  • Retrospective analysis, National Health Interview Survey data.
  • Funding: US Department of Health and Human Services.

Limitations

  • Sparse data.
  • Underestimated vulnerability rates for ethnic/racial groups.
  • Aging data drive CDC vulnerabilities list.