It is well documented that comorbidities predispose adults to serious illnesses. One question that arises is whether the risk factors are the same for young adults as for older adults. Molani et al. study this and find that the risk factors for serious illness from SARS-CoV-2 differ between these two age groups.
The retrospective study carried out by Molani et al. reviews more than 6,900 medical records, correlating the effects of age, comorbidities, and symptom severity of contracting SARS-CoV-2.
Participating patients included people hospitalized after testing positive for SARS-CoV-2 between June 31 and November 15, 2021. Patients on mechanical ventilation were excluded from this study. The sample ranged from 51 hospitals and 1081 clinics in five states. The patients were then divided into two subgroups: the youngest (age ≥ 18 years and
Molani et al. hypothesized that these age-stratified groups would allow correct interpretation of SARS-CoV-2 mortality based solely on patient medical history. Some of the factors they analyzed in this study include patient demographics, medical history, vital signs, and laboratory biomarkers. Due to the varying conditions of each patient, they analyzed the group as a whole as well as by age group. This would help circumvent differences in chronic diseases present prior to infection, or even vaccination status.
The three main conclusions were: 1) risk models are effective in analyzing clinical data, 2) vital signs and laboratory test results at the time of admission are more important in predicting severe symptoms of COVID-19. 19 than the presence of comorbidities, 3) age—stratified models show that the severity of symptoms between younger and older people with COVID-19 is different.
Statistical analysis revealed new insights into how variables that correlate with severe infection or even death from SARS-CoV-2 differ between younger and older age groups. For example, Molani et al. found that younger patients with cardiac comorbidities and a high BMI are more likely to suffer from severe symptoms than older patients. Conversely, older patients with dementia or vasopressors are more likely to experience severe SARS-CoV-2 symptoms than younger patients (Table 1).
Based on the analysis, Molani et al. noted that body mass index is a better predictor of SARS-Cov-2 severity in young people. It shows no significant correlation for the elderly population. Molani et al. note that future research may involve models stratified by BMI to determine the risks of being underweight or overweight in young adults.
They also found that many comorbidities such as higher AST which leads to liver damage, higher creatinine which impairs kidney function, lower calcium levels, older age and higher BMI put the population at higher risk. young people at increased risk of severe Covid-19 symptoms. Finally, for young and older patients, it is more effective to check vital signs and perform laboratory tests for predictions most of the time, than to rely on comorbidities and patient demographics.
This study highlights the need for early risk stratification in patients with SARS-CoV-2 to determine the level of care a patient is likely to need. Molani et al. used readily available data such as demographics, vital signs, laboratory tests, and medical history to predict the severity of SARS-CoV-2 in a patient. Therefore, the age-stratified modeling approach provides us with a more holistic understanding of patient risk factors and how this should translate into the healthcare decisions that are made.