tetano
Editor, Senior Moderator
JAMA Intern Med
. 2026 Jan 5:e257179.
doi: 10.1001/jamainternmed.2025.7179. Online ahead of print. Estimated Burden of COVID-19 Illnesses, Medical Visits, Hospitalizations, and Deaths in the US From October 2022 to September 2024
Emilia H A Koumans[SUP] 1 [/SUP], Diba Khan[SUP] 1 [/SUP], Imelda Trejo[SUP] 1 [/SUP], Li Deng[SUP] 1 [/SUP], Owen Devine[SUP] 1 [/SUP], Sarah E Smith-Jeffcoat[SUP] 1 [/SUP], Sarah Hamid[SUP] 1 [/SUP], Monica E Patton[SUP] 1 2 [/SUP], Emily Carter[SUP] 1 [/SUP], Megha Aggarwal[SUP] 1 [/SUP], Huong Pham[SUP] 1 [/SUP], Kadam Patel[SUP] 1 [/SUP], Michael Whitaker[SUP] 1 [/SUP], Ryan E Wiegand[SUP] 1 [/SUP], Cria O Gregory[SUP] 2 3 [/SUP], Ismael R Ortega-Sanchez[SUP] 1 [/SUP], Gordana Derado[SUP] 1 [/SUP], A Danielle Iuliano[SUP] 4 [/SUP], Carrie Reed[SUP] 4 [/SUP], Aron J Hall[SUP] 5 [/SUP], Christopher A Taylor[SUP] 1 [/SUP], Fiona Havers[SUP] 1 2 [/SUP]; Estimate of Burden of COVID-19 Workgroup; Bridget J Anderson[SUP] 6 7 [/SUP], Edwin Asturias[SUP] 8 9 10 [/SUP], Natalie M Bowman[SUP] 9 11 [/SUP], Shua J Chai[SUP] 7 12 13 [/SUP], Helen Y Chu[SUP] 14 15 [/SUP], Kathryn Como-Sabetti[SUP] 7 16 [/SUP], Katherine D Ellingson[SUP] 9 17 [/SUP], Christina B Felsen[SUP] 7 18 [/SUP], Carlos G Grijalva[SUP] 9 19 [/SUP], Mary Hill[SUP] 7 20 [/SUP], Breanna Kawasaki[SUP] 7 21 [/SUP], Karen Lutrick[SUP] 9 17 [/SUP], Yvonne Maldonado[SUP] 9 22 [/SUP], Emily T Martin[SUP] 23 24 [/SUP], Arnold S Monto[SUP] 23 24 [/SUP], Kerry Grace Morrissey[SUP] 9 25 [/SUP], Allison L Naleway[SUP] 26 27 [/SUP], Huong Q Nguyen[SUP] 9 28 [/SUP], Julie Plano[SUP] 7 29 [/SUP], Suchitra Rao[SUP] 9 30 [/SUP], Patricia A Ryan[SUP] 7 31 [/SUP], Daniel M Sosin[SUP] 7 32 [/SUP], Melissa S Stockwell[SUP] 9 33 [/SUP], Melissa Sutton[SUP] 7 34 [/SUP], H Keipp Talbot[SUP] 7 9 19 [/SUP], Lucy S Witt[SUP] 7 35 36 [/SUP]
Affiliations
Importance: Since 2020, COVID-19 has dramatically impacted the US population and health care system. Reporting requirements, circulating variants, testing practices, and population immunity from vaccination and previous infections evolved as the COVID-19 pandemic progressed. Evidence-based public health policy and resource allocation decisions require current estimates of disease burden.
Objective: To estimate the age group-specific burden of COVID-19-associated illnesses, outpatient visits, hospitalizations, and deaths in the US from October 2022 to September 2024.
Design, setting, and participants: In this cross-sectional study, hierarchical Bayesian modeling, adjusting for underdetection of SARS-CoV-2 due to testing practices and test sensitivity, was applied to hospitalization data from the population-based COVID-19 Hospitalization Surveillance Network (COVID-NET) database, which includes 89 counties and jurisdictional equivalents in 12 states covering approximately 10% of the US population. Data from 94 363 participants from October 2022 to September 2023 (surveillance period, 2022-2023) and from 72 176 participants from October 2023 to September 2024 (surveillance period, 2023-2024) were included, and probabilistic mathematical multiplier models estimated counts of deaths, outpatient visits, and symptomatic illnesses incorporating literature and study-based multipliers. Data were modeled from April 2024 to September 2025.
Exposures: COVID-NET patients with a laboratory-confirmed COVID-19-associated hospitalization, defined as a positive SARS-CoV-2 test result within 14 days before or during hospitalization.
Main outcomes and measures: Estimated national counts with 95% uncertainty intervals (UIs) of outpatient visits, illnesses, hospitalizations, and deaths by age group.
Results: In 2022-2023, there were an estimated 43.6 million (95% UI, 25.3-64.0 million) COVID-19-associated illnesses, 10.0 million (95% UI, 7.0-13.1 million) outpatient visits, 1.1 million (95% UI, 0.9-1.4 million) hospitalizations, and 101 300 (95% UI, 73 600-132 500) deaths. In 2023-2024, there were an estimated 33.0 million (95% UI, 20.2-49.0 million) COVID-19-associated illnesses, 7.7 million (95% UI, 5.5-9.9 million) outpatient visits, 879 100 (95% UI, 738 600-1 039 000) hospitalizations, and 100 800 (95% UI, 64 000-140 400) deaths. In 2023-2024, people 65 years and older comprised 17.7% of the total US population but accounted for 47.9% (95% UI, 27.1-66.9) of COVID-19-associated illnesses, 64.3% (95% UI, 53.1-73.4) of outpatient visits, 67.6% (95% UI, 65.9-69.2) of hospitalizations, and 81.2% (95% UI, 70.2-90.6) of deaths.
Conclusions and relevance: In this cross-sectional study, despite declining from the first to the second surveillance period, the COVID-19 burden continued to have a large impact in the US, particularly among adults 65 years and older, underscoring the ongoing importance of prevention measures.
. 2026 Jan 5:e257179.
doi: 10.1001/jamainternmed.2025.7179. Online ahead of print. Estimated Burden of COVID-19 Illnesses, Medical Visits, Hospitalizations, and Deaths in the US From October 2022 to September 2024
Emilia H A Koumans[SUP] 1 [/SUP], Diba Khan[SUP] 1 [/SUP], Imelda Trejo[SUP] 1 [/SUP], Li Deng[SUP] 1 [/SUP], Owen Devine[SUP] 1 [/SUP], Sarah E Smith-Jeffcoat[SUP] 1 [/SUP], Sarah Hamid[SUP] 1 [/SUP], Monica E Patton[SUP] 1 2 [/SUP], Emily Carter[SUP] 1 [/SUP], Megha Aggarwal[SUP] 1 [/SUP], Huong Pham[SUP] 1 [/SUP], Kadam Patel[SUP] 1 [/SUP], Michael Whitaker[SUP] 1 [/SUP], Ryan E Wiegand[SUP] 1 [/SUP], Cria O Gregory[SUP] 2 3 [/SUP], Ismael R Ortega-Sanchez[SUP] 1 [/SUP], Gordana Derado[SUP] 1 [/SUP], A Danielle Iuliano[SUP] 4 [/SUP], Carrie Reed[SUP] 4 [/SUP], Aron J Hall[SUP] 5 [/SUP], Christopher A Taylor[SUP] 1 [/SUP], Fiona Havers[SUP] 1 2 [/SUP]; Estimate of Burden of COVID-19 Workgroup; Bridget J Anderson[SUP] 6 7 [/SUP], Edwin Asturias[SUP] 8 9 10 [/SUP], Natalie M Bowman[SUP] 9 11 [/SUP], Shua J Chai[SUP] 7 12 13 [/SUP], Helen Y Chu[SUP] 14 15 [/SUP], Kathryn Como-Sabetti[SUP] 7 16 [/SUP], Katherine D Ellingson[SUP] 9 17 [/SUP], Christina B Felsen[SUP] 7 18 [/SUP], Carlos G Grijalva[SUP] 9 19 [/SUP], Mary Hill[SUP] 7 20 [/SUP], Breanna Kawasaki[SUP] 7 21 [/SUP], Karen Lutrick[SUP] 9 17 [/SUP], Yvonne Maldonado[SUP] 9 22 [/SUP], Emily T Martin[SUP] 23 24 [/SUP], Arnold S Monto[SUP] 23 24 [/SUP], Kerry Grace Morrissey[SUP] 9 25 [/SUP], Allison L Naleway[SUP] 26 27 [/SUP], Huong Q Nguyen[SUP] 9 28 [/SUP], Julie Plano[SUP] 7 29 [/SUP], Suchitra Rao[SUP] 9 30 [/SUP], Patricia A Ryan[SUP] 7 31 [/SUP], Daniel M Sosin[SUP] 7 32 [/SUP], Melissa S Stockwell[SUP] 9 33 [/SUP], Melissa Sutton[SUP] 7 34 [/SUP], H Keipp Talbot[SUP] 7 9 19 [/SUP], Lucy S Witt[SUP] 7 35 36 [/SUP]
Affiliations
- PMID: 41489910
- PMCID: PMC12771391 (available on 2027-01-05)
- DOI: 10.1001/jamainternmed.2025.7179
Importance: Since 2020, COVID-19 has dramatically impacted the US population and health care system. Reporting requirements, circulating variants, testing practices, and population immunity from vaccination and previous infections evolved as the COVID-19 pandemic progressed. Evidence-based public health policy and resource allocation decisions require current estimates of disease burden.
Objective: To estimate the age group-specific burden of COVID-19-associated illnesses, outpatient visits, hospitalizations, and deaths in the US from October 2022 to September 2024.
Design, setting, and participants: In this cross-sectional study, hierarchical Bayesian modeling, adjusting for underdetection of SARS-CoV-2 due to testing practices and test sensitivity, was applied to hospitalization data from the population-based COVID-19 Hospitalization Surveillance Network (COVID-NET) database, which includes 89 counties and jurisdictional equivalents in 12 states covering approximately 10% of the US population. Data from 94 363 participants from October 2022 to September 2023 (surveillance period, 2022-2023) and from 72 176 participants from October 2023 to September 2024 (surveillance period, 2023-2024) were included, and probabilistic mathematical multiplier models estimated counts of deaths, outpatient visits, and symptomatic illnesses incorporating literature and study-based multipliers. Data were modeled from April 2024 to September 2025.
Exposures: COVID-NET patients with a laboratory-confirmed COVID-19-associated hospitalization, defined as a positive SARS-CoV-2 test result within 14 days before or during hospitalization.
Main outcomes and measures: Estimated national counts with 95% uncertainty intervals (UIs) of outpatient visits, illnesses, hospitalizations, and deaths by age group.
Results: In 2022-2023, there were an estimated 43.6 million (95% UI, 25.3-64.0 million) COVID-19-associated illnesses, 10.0 million (95% UI, 7.0-13.1 million) outpatient visits, 1.1 million (95% UI, 0.9-1.4 million) hospitalizations, and 101 300 (95% UI, 73 600-132 500) deaths. In 2023-2024, there were an estimated 33.0 million (95% UI, 20.2-49.0 million) COVID-19-associated illnesses, 7.7 million (95% UI, 5.5-9.9 million) outpatient visits, 879 100 (95% UI, 738 600-1 039 000) hospitalizations, and 100 800 (95% UI, 64 000-140 400) deaths. In 2023-2024, people 65 years and older comprised 17.7% of the total US population but accounted for 47.9% (95% UI, 27.1-66.9) of COVID-19-associated illnesses, 64.3% (95% UI, 53.1-73.4) of outpatient visits, 67.6% (95% UI, 65.9-69.2) of hospitalizations, and 81.2% (95% UI, 70.2-90.6) of deaths.
Conclusions and relevance: In this cross-sectional study, despite declining from the first to the second surveillance period, the COVID-19 burden continued to have a large impact in the US, particularly among adults 65 years and older, underscoring the ongoing importance of prevention measures.