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It’s not just older adults at risk for a serious case of COVID-19. Getty Images
  • At the start of the pandemic, it seemed like the new coronavirus only seriously affected older adults.
  • Now, it’s become increasingly clear that younger people, including those in their 20s, can develop severe COVID-19, too.
  • A new study finds a third of young people are at risk for severe COVID-19.

A new study from the University of California, San Francisco (UCSF) has found that 1 in 3 young adults between the ages of 18 and 25 are susceptible to contracting a severe form of COVID-19 requiring hospitalization.

The paper, published in the Journal of Adolescent Health on Monday, found that smoking — both cigarettes and e-cigarettes — largely contributes to the group’s risk.

While smoking was the greatest risk factor, obesity, asthma, diabetes, and immune disorders often contribute to young people’s risk of getting severely sick with COVID-19 too.

Meanwhile, stories have emerged in recent weeks of young adults — some of whom seemed to be otherwise healthy before getting sick — experiencing severe complications and even dying from COVID-19.

At the start of the pandemic, it seemed like the new coronavirus only seriously affected older adults. Now, it’s become increasingly clear that younger people, including those in their 20s, can develop severe COVID-19 too.

“The fundamental philosophy that youth is protective is being dismantled. Increased levels of obesity, smoking, and a sedentary lifestyle are putting our youth at risk from a much earlier age than we have seen in the past,” said Dr. Sharon Chekijian, a Yale Medicine emergency medicine physician.

The researchers evaluated the health data of over 8,000 young adults ages 18 to 25, which was sourced from the National Health Interview Survey.

They studied how many people in the group had a risk factor or medical vulnerability for COVID-19, like diabetes, obesity, an immune disorder, heart condition, or if they smoke.

The team found that 32 percent of the population was at risk for the disease.

That percentage was greatly influenced by cigarette and e-cigarette smokers.

When smokers were removed from the equation, the percentage was halved: Just 16 percent of young adults were at risk for severe COVID-19.

The researchers were surprised to discover that so many young adults were at risk for severe COVID-19.

“We decided to look at this group and the findings were 1 in 3 of them of the sample that we looked at were susceptible,” senior author Dr. Charles Irwin Jr., the director of UCSF’s division of adolescent and young adult medicine, told Healthline.

What surprised them was how big of a role smoking played in the group’s risk — it mattered more than obesity and asthma, according to Irwin.

“We were shocked,” Irwin added. “It’s a really risky period of time for young people.”

This study highlights the impact smoking has on people’s health, no matter their age.

“This irritant disrupts the airway epithelial barrier, and this disruption and loss of protection makes it easier to contract infections,” said Dr. Laren Tan, the medical director of the Comprehensive Program for Obstructive Airway Diseases at Loma Linda University Health.

When exposed to a virus like this one, smokers with injured lung capacity are at a greater disadvantage, compared with those who don’t smoke and have healthy lungs, Tan noted.

At the start of the pandemic, the focus was mostly on how COVID-19 affected older adults — especially those 65 and up.

Now, the conversation has shifted as more and more young people in their 20s have gotten extremely sick with COVID-19.

It’s natural to wonder what led to this change: How and why did young adults become so vulnerable?

Some health experts suspect it’s because some young adults went to bars, restaurants, and beaches when states reopened, making themselves more vulnerable to contracting the virus and developing COVID-19.

“We know that adolescents and young adults engage in risky behavior at a higher rate than their older counterparts,” Chekijian said.

And during the pandemic, the riskier your behavior, the greater your odds are for getting COVID-19.

But Irwin thinks it has more to do with the fact that the coronavirus is just more widespread than it was a couple of months ago.

More young adults are getting sick because more people, in general, are spreading the coronavirus.

One of Irwin’s concerns regarding these findings is that many young adults don’t have a regular healthcare provider.

Less than 25 percent had a preventive visit in the past year. Most don’t have a primary care physician or doctor other than what their college may provide, if they attend.

“If you look at the utilization for healthcare in this group, it’s really incredibly low,” Irwin said.

Consequently, some younger people may not know they have a chronic illness until they develop COVID-19, have complications, and are evaluated in a hospital.

“Being healthy is extremely hard to assess unless they are up to date on their primary care visits and healthcare,” Tan said.

Tan says in his experience, many younger people didn’t know they had an underlying condition — like diabetes, asthma, or obesity — until they were admitted to the intensive care unit for severe COVID-19.

So, what should young adults take away here?

Irwin says smoking needs to be addressed. It’s a huge risk factor for COVID-19, especially amongst the 18- to 25-year-old crowd.

The good news, according to Irwin, is that smoking is modifiable. People can quit or change their smoking habits at any time and immediately reduce their risk.

“I’m hoping the message from this paper will be used by clinicians to reemphasize the importance of stopping to smoke or cutting down your smoking behavior,” Irwin said.

New research looked at the health data of people between the ages of 18 and 25 and found that 32 percent of young adults are susceptible to developing a severe form of COVID-19 requiring hospitalization. The group’s overall risk was greatly influenced by whether or not they smoke — when the researchers removed smoking from the equation, young adults’ risk for severe COVID-19 dropped to 16 percent.