COVID-19 Disease in Hospitalised Young Adults in India and China: Evaluation of Risk Factors Predicting Progression Across Two Major Ethnic Groups.

Panda, Smriti; Roy, Sankanika; Garg, Rohit K; Hui, Gan; Gorard, Jack; Bhutada, Mayank; Sun, Yuanli; Bhatnagar, Sushma; Mohan, Anant; Dar, Lalit; Liu, Mao

Data pertaining to risk factor analysis in COVID-19 is confounded by the lack of data from ethnically diverse population. In addition, there is lack of data for young adults. This study was conducted to assess risk factors predicting COVID19 severity and mortality in hospitalised young adults. A retrospective observational study was conducted at two centres from China and India on COVID-19 patients aged 20-50 years. Regression analysis to predict adverse outcome was performed using parameters including age, sex, country of origin, hospitalization duration, comorbidities, lymphocyte count and NEWS2 score at admission. 420 patients (172 East-Asians and 248 South-Asians) were included. The predictive model for ICU admission with variables NEWS2 category II and higher, diabetes mellitus, liver dysfunction and low lymphocyte counts had an area under the curve (AUC) value of 0.930 with a sensitivity of 0.931 and a specificity of 0.784. The predictive model for mortality with NEWS2 category III, cancer and decreasing lymphocyte count had an AUC value of 0.883 with a sensitivity of 0.903 and a specificity of 0.701. A combined predictive model with bronchial asthma and low lymphocyte count, in contrast, had an AUC value of 0.768 with a sensitivity of 0.828 and a specificity of 0.719 for NEWS 2 score (5 or above) at presentation. NEWS2 supplemented with comorbidity profile and lymphocyte count could help identify hospitalised young adults at risk of adverse COVID-19 outcome. This article is protected by copyright. All rights reserved.