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Background Our objective was to characterize young adult patients hospitalized with coronavirus disease 2019 (COVID-19) and identify predictors of survival at 30 days. Methods This retrospective cohort study took place at 12 acute care hospitals in the New York City area. Patients aged 18–39 hospitalized with confirmed COVID-19 between March 1 and April 27, 2020 were included in the study. Demographic, clinical, and outcome data were extracted from electronic health record reports. Results A total of 1013 patients were included in the study (median age, 33 years; interquartile range [IQR], 28–36; 52% female). At the study end point, 940 (92.8%) patients were discharged alive, 18 (1.8%) remained hospitalized, 5 (0.5%) were transferred to another acute care facility, and 50 (4.9%) died. The most common comorbidities in hospitalized young adult patients were obesity (51.2%), diabetes mellitus (14.8%), and hypertension (13%). Multivariable analysis revealed that obesity (adjusted hazard ratio [aHR], 2.71; 95% confidence interval [CI], 1.28–5.73; P = .002) and Charlson comorbidity index score (aHR, 1.20; 95% CI, 1.07–1.35; P = .002) were independent predictors of in-hospital 30-day mortality. Conclusions Obesity was identified as the strongest negative predictor of 30-day in-hospital survival in young adults with COVID-19.

In-Hospital 30-Day Survival Among Young Adults With Coronavirus Disease 2019: A Cohort Study