The coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has ravaged across the globe, affecting people from all walks of life. High-risk populations are at a heightened risk of severe illness and death, including the elderly and those with underlying medical conditions.
The COVID-19 has caused a marked increase in all-cause deaths in the United States, particularly among the elderly above 65 years old. Since younger adults have lower infection fatality rates, little attention has been focused on the mortality burden of COVID-19 in this age group.
A team of researchers at Brigham and Women's Hospital, Department of Emergency Medicine, Harvard Medical School, aimed to determine changes in all-cause mortality or excess deaths among adults between 25 and 44 years old in the United States. Further, they also want to identify the years of lost life (YLL) among this age group.
The team used data provided by the National Center for Health Statistics at the United States Centers for Disease Control and Prevention (CDC) to arrive at the study findings. The data consists of the most recent public data for all-cause mortality between 2019 and 2020, unintentional drug overdose deaths, unintentional opioid-specific deaths, and COVID-19 deaths among adults ages 25 to 44 during the COVID-19 pandemic in the country.
The team compared COVID-19-related deaths in the age group during the pandemic period with all drug overdose deaths and opioid-specific overdose deaths in each of the 10 Health and Human Services (HHS) regions during 2018, the most recent year for which data are available.
Also, they computed for the YLL due to COVID-19 and for all-cause excess deaths that happened between March and July. Excess mortality means the deaths that occurred in 2020, less the 2019 deaths during the corresponding period.
Unintentional overdose deaths, opioid deaths, and COVID-19 deaths among persons aged 25-44, per 100,000 person-month (vertical axis) by month (horizontal axis), stratified by HHS region. Bars: Unintentional drug overdose deaths (ICD10 X41-X45, Y11-Y15), 2018 (light blue with 95% CI) and opioid-specific drug overdose deaths (ICD10 X41-X45, Y11-Y15 and T40.0-40.6), 2018 (dark blue with 95% CI). Lines: COVID-19 deaths (ICD10 U071), 2020; colors are stratified by regional COVID-19 case incidence per 1,000,000 residents through July 31, 2020 (green <1,050 cases per 100,000 residents; yellow 1,050-1,499 cases per 100,000 residents; red >1,500 cases per 100,000 residents). HHS Regions: Region 1: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont; Region 2: New Jersey and New York; Region 3: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia; Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee; Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin; Region 6: Arkansas, Louisiana, New Mexico, Oklahoma, and Texas; Region 7: Iowa, Kansas, Missouri, and Nebraska; Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming; Region 9: Arizona, California, Hawaii, and Nevada; Region 10: Alaska, Idaho, Oregon, and Washington.
What the study found
In the study, published in the pre-print journal medRxiv*, the team has found that between March and July 2020, there were more than 74,000 all-cause deaths among adults between 25 and 44 years old.
The number is 14,155 more than during the same period in 2019, up by 23 percent. In regions such as New York, New Jersey, Louisiana, Arkansas, Oklahoma, New Mexico, Texas, California, Arizona, Nevada, and Hawaii, the deaths tied to COVID-19 exceeded the 2018 unintentional opioid overdose deaths during at least one month.
Overall, there were 2,450 COVID-19 deaths recorded in these states during the pandemic compared to 2,445 opioid deaths during the same period in 2018. From March to July in 2018, the U.S. has recorded 10,347 deaths related to opioid overdosage, leading to 472,608 YLL among adults between 25 and 44 years old.
Amid the pandemic, there were 4,055 recorded COVID-19 deaths in the same age group, resulting in 175,631 YLL. When the team considered all of the 14,155 excess deaths in 2020, young adults accounted for 627,872 YLL, surpassing the YLL from overdose-related deaths during the same period in 2018.
Based on the study findings, the team concluded that COVID-19 has likely become the leading cause of death among young adults in some areas of the U.S. during the pandemic. The team also noted that in these regions, the COVID-19 related mortality is similar to the human immunodeficiency virus (HIV)/ Acquired Immunodeficiency Disease Syndrome (AIDS) epidemic at its peak in the country between 1994 and 1995.
U.S. COVID-19 numbers
For months, the U.S. has become the hardest-hit country during the coronavirus pandemic. The country has now reported over 8.6 million cases and at least 225,000 deaths. New York reports the highest number of deaths, surpassing 33,000.
Apart from the U.S., other countries with high coronavirus cases include India, with more than 7.86 million cases, Brazil, with more than 5.38 million cases, Russia, with more than 1.5 million cases, France, with more than 1.13 million cases, among others.
Globally, the COVID-19 case toll has topped 42.92 million, and the infection has now claimed more than 1.15 million deaths. Of these, at least 28.89 million have already recovered.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.