COVID-19 morbidity and mortality in young people in selected countries of the Americas

While COVID-19 primarily affected adults, the epidemiology among adolescents and young adults has been less explored. This study describes the burden, outcomes, and correlates of COVID-19 among people aged 10–24 years in selected countries in the Americas during the acute pandemic phase (2020–mid-2022). We analyzed case-based surveillance data reported by 32 countries and territories to the Pan American Health Organization between January 2020 and July 2022. Confirmed and probable SARS-CoV-2 infections were included following WHO definitions. We described age, sex, and temporal distributions, estimated cumulative incidence, and assessed associations between recovery status, comorbidities, and treatment modalities using logistic regression models adjusted for age and sex. A total of 17,031,217 COVID-19 cases were reported among young people (72% aged 10–19; 28% aged 20–24). Females accounted for 53% of cases. The pooled cumulative incidence was 7.7 per 100 population aged 10–24, ranging from 0.1 in Cuba to 52.0 in Bonaire, Sint Eustatius, and Saba. Recovery was documented in 88.9% of adolescents and 87.0% of young adults. The odds of recovery were lower among those aged 20–24 years (aOR 0.84, 95% CI 0.83–0.84), those with ≥ 1 comorbidity (aOR 0.17, 95% CI 0.16–0.18), and those requiring ventilatory support (aOR 0.28, 95% CI 0.25–0.31). Females and hospitalized patients had slightly higher recovery odds. Cardiovascular, kidney, and diabetic comorbidities were significantly associated with increased mortality. Young people in the Americas represented a substantial proportion of COVID-19 cases, though with low overall mortality. However, chronic conditions markedly increased the risk of poor outcomes. Strengthening surveillance, ensuring continuity of care for young people with chronic diseases, and tailoring risk communication are essential components of future pandemic preparedness and life-course health strategies.