Luo J, Rosales M, Wei G, Stoddard GJ, Kwok AC, Jeyapalina S, Agarwal JP. Hospitalization, mechanical ventilation, and case-fatality outcomes in US veterans with COVID-19 disease between years 2020-2021.
Ann Epidemiol 2022;
70:37-44. [PMID:
35462045 PMCID:
PMC9021125 DOI:
10.1016/j.annepidem.2022.04.003]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 03/31/2022] [Accepted: 04/10/2022] [Indexed: 01/28/2023]
Abstract
PURPOSE
Although veterans represent a significant proportion (7%) of the USA population, the COVID-19 disease impact within this group has been underreported. To bridge this gap, this study was undertaken.
METHOD
A total of 419,559 veterans, who tested positive for COVID-19 disease in the Veterans Affairs hospital system from March 1st, 2020 to December 31st, 2021 with 60-days follow-up, was included in this retrospective review. Primary outcome measures included age-adjusted incidences and relative incidences of COVID-19 hospitalization, mechanical ventilation, and case-fatality outcomes.
RESULTS
Of this veteran cohort with COVID-19 disease, predominately 85.7% were male, 59.1% were White veterans, 27.5% were ages 50-64, and 40.5% were obese. Although Black veterans were at 63% higher relative risk (RR) for hospitalization incidences, they had a similar risk RR for in-hospital deaths compared to the White-veteran referent. Asian, American Indian/Alaska Native races, advanced age ≥65, and the underweight were at high RR for mechanical ventilator and/or in-hospital deaths compared to respective referent groups. Veterans who are ≥85 years old had a nearly 5-fold higher incidence of death compared respective referent group. The monthly outcomes for hospitalization, ventilation, and case-fatality data showed decreasing trends with time.
CONCLUSION
An increased incidence of death was associated with age ≥65 years and underweight veterans compared to the referent group. Age-adjusted data, however, did not show any increased incidence of death in Black veterans compared to White veterans.
RATINGS OF THE QUALITY OF THE EVIDENCE
3 (Case-control studies; retrospective cohort study).
Collapse