10-24-year-olds are as susceptible to COVID-19 as older adults

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent behind the ongoing coronavirus disease 2019 (COVID-19) pandemic.

Population-based surveys on COVID-19 prevalence have helped establish the epidemiology of infection and allowed more accurate decision-making regarding re-opening policies.

The susceptibility of adolescents (10-19 years) and youth (15-24 years) to COVID-19 have been a controversial topic ever since the pandemic declaration.

According to the WHO, adolescents fall in the 10-19 age group, and youth belong to the 15-24 age group. Early studies performed in Hunan province, China, reported the infection rate in 0-14-year-olds as 6.2% compared to an infection rate of 8.6% in 15-64-year-olds and 16.3% in individuals 65 years and above.

Several other studies have also reported that adolescents are significantly less prone to COVID-19 compared to older adults. As per these results, older adults were deemed significantly more susceptible to COVID-19 than adolescents and youth.

Statistical analyses to compare COVID-19 prevalence in adolescents and youth to older adults

In an attempt to replicate the results of previous studies, a team of researchers from the New York Medical College, Touro College & University System, SUNY Downstate College of Medicine, and Icahn School of Medicine at Mount Sinai, New York, USA, performed statistical analyses on COVID-19 prevalence data from the U.S. to compare the number of cases in adolescents and youth to that in older adults. Their work is published on the preprint server medRxiv*.

The researchers analyzed data from 6 U.S. states experiencing an increase in the number of COVID-19 cases to determine the prevalence of COVID-19 and two other parameters pertaining to COVID-19 prevalence in youth and adolescents to older adults. The 2 parameters were (% of cases observed in a given age group) ÷ (% of cases expected based on population demographics); and percentage deviation or [(% observed - % expected)/ % expected] x 100.

COVID-19 prevalence in adolescence significantly greater than in older adults

As per the results obtained, the prevalence of COVID-19 in adolescents and youth was considerably higher than that in older adults (p < .00001), as was % observed ÷ % expected (p < .005).

"Our findings in the six U.S. states are contrary to those of Zhang et al. in China who found that the infection rate in older adults, ages 65+, exceeded that in adolescents and youth, and to those of Wu et al., who found that of 44,672 confirmed cases of COVID in mainland China, only 1% were in adolescents ages 10-19 years of age."

The % deviation was significantly higher in adolescents/youth compared to that in older adults
(p < 0.00001) when observed cases were more than the expected numbers and significantly less when observed numbers were fewer than expected (p < 0.00001).  

"We found that the prevalence of COVID-19 in adolescence was significantly greater than in older adults, and similarly for the two other prevalence-related measures."

High susceptibility of adolescents and youth to COVID-19 highlights the need for masks and social distancing in schools

The study results did not agree with the findings of previous studies that concluded adolescents are less susceptible to COVID-19 than older adults. This work's findings indicate a similar infection rate for all the age groups, which can have crucial implications for the re-opening of schools.

Students in middle and high schools, college, and the first two years of professional / graduate schools fall in the age groups of 10-19 and 15-24. The high prevalence of COVID-19 in these age groups indicates the need for an abundance of caution while making decisions regarding school re-openings. In countries where schools have already re-opened, the high prevalence of COVID-19 in these age groups emphasizes the necessity of students, teachers, and staff using masks, following social distancing, and regular sanitizing and washing hands.

"In places where schools have nevertheless re-opened, the high prevalence of COVID-19 highlights the necessity of students, faculty, and staff wearing masks, social distancing, and washing hands regularly."

*Important Notice

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.

Journal reference:
Susha Cheriyedath

Written by

Susha Cheriyedath

Susha has a Bachelor of Science (B.Sc.) degree in Chemistry and Master of Science (M.Sc) degree in Biochemistry from the University of Calicut, India. She always had a keen interest in medical and health science. As part of her masters degree, she specialized in Biochemistry, with an emphasis on Microbiology, Physiology, Biotechnology, and Nutrition. In her spare time, she loves to cook up a storm in the kitchen with her super-messy baking experiments.


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