Why are young, healthy people dying of coronavirus? The symptoms to look out for

Aren’t healthy young people immune?

No. Anyone can catch coronavirus. The youngest person to be diagnosed with the disease in the UK was a newborn baby. In most cases, younger people will experience milder symptoms of Covid-19, and some may not have symptoms at all, but people of all ages could become critically ill.

However, other cases have been emerging which show the virus to have affected those who are also young.

A London hospital trust confirmed that a 13-year-old boy who tested positive for coronavirus died at King’s College Hospital on Monday. He had no apparent underlying conditions. 

A 19-year-old aspiring chef, Luca di Nicola, also died on March 24 in London after suffering from chest pains due to Covid-19.

Of 1,415 people, among the first to be diagnosed with Covid-19, around half were aged between 15 to 49, according to Wei-jie Guan, of the China Medical Treatment Expert Group. Nine were aged 14 and under.

I am in my 40s, will I experience milder symptoms?

Although 80 per cent of people will experience mild symptoms of Covid-19, such as a cough and fever, according to the Chinese Centers for Disease Control and Prevention, age is no guarantee.

“Anyone can get infected,” says Dr Bharat Pankhania, senior clinical lecturer in medicine at the University of Exeter. “And the disease progression is unpredictable.”

One reason people become critically ill with coronavirus, Dr Pankhania continues, could be because their immune system goes into overdrive, causing something called a ‘cytokine storm’ – an overproduction of immune cells.

“Once it has started, it is like a chain reaction, where your body overreacts to the virus,” he says. “Pneumonia can become a lot more severe and move into other organs. Whilst the elderly get a kicking from the virus and have comorbidities that reduce their defences, otherwise healthy young people can have an overreaction and there is absolutely no telling who will be affected.”

Can young people die from Covid-19?

Imperial College, London whose modelling informs the UK Scientific Advisory Group for Emergencies, predicts that in Britain only 0.03 per cent of people under 30 who contract the virus will die, compared to a frightening 9.3 per cent of those over 80. The death rate climbs in a shallow curve up to age 50 before swinging upward at pace.

However it is perfectly possible for Covid-19 to be both a “disease of the old” and for very large numbers of young people to die. “The message should be that young, healthy people are dying from this infection,” says Paul Hunter, professor in medicine at the UEA. “You’re not risk free.”

It’s also important to note that very young children may be more vulnerable to Covid-19 than first thought, according to a study published by the American Academy of Pediatrics. The study, which looked at 2,143 patients under the age of 18 in China, found the rate of “severe and critical” illness in infants under one was 10.6 per cent. The study also revealed a 14-year-old boy from Hubei province died from the virus.

On March 25, 21-year-old Chloe Middleton from Buckinghamshire, who suffered from no pre-existing health conditions, sadly died of coronavirus.

She is thought to be the youngest victim of coronavirus with no pre-existing health conditions in the UK.

Are symptoms different in younger people?

The main indicators of the disease are the same for all ages: fever, dry cough, headache, and body aches. There have been reports of younger people experiencing losing their senses of smell and taste, with few other symptoms, but it isn’t clear if this is caused by Covid-19. “With an open mind I would say it’s entirely biologically plausible that you lose your smell and taste before the experience of a full blown infection,” says Dr Pankhania. “It shows the virus is attacking via the mouth and nose.”

The signs that an infection is becoming critical are the same for people of every age: “Shortness of breath and difficulty breathing is a key indicator that your lungs have now got viral pneumonia,” says Dr Pankhania. “If you experience this, you need to call for help as soon as possible.”  

Can your ‘viral load’ affect how ill you get?

The term viral load refers to the amount of viral particles present in your body. Some early research has suggested people who are exposed to a larger viral load could experience worse symptoms when they become ill.

“A few deaths in younger people seem to be medics, who have been exposed to very high doses of the virus by treating lots of people with it on the same day,” says Prof Hunter. “If your antibodies kick in and start reducing your viral load early enough then you won’t get severely ill.” The length and frequency of your exposure to the virus can make this battle more difficult to win, he adds.

Should I be as careful as my 70-plus parents?

People who are 70 and over are still statistically more likely to become critically ill from Covid-19, because they have weaker immune system than younger people.

“The quality of your immune system deteriorates as you get older,” says Prof Hunter. “You are not as good at producing antibodies as a 20-year-old.”

However, on Monday, Dr Rosena Allin-Khan, a London doctor and Labour MP, issued an urgent plea to the young. “Some of the sickest patients that we have had in this department recently have been young,” she told the BBC. “We have patients who are in their 30s and early 40s who are previously fit and well who are now in intensive care and fighting for their lives.”

It was a warning echoed by Dr Tedros Adhanom Ghebreyesus, director general of the World Health Organization (WHO). “You are not invincible”, he told young people. “This virus could put you in hospital for weeks, or even kill you… people under 50 make up a significant proportion of patients requiring hospitalisation”.

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