tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2021 Nov 10;8(12)
fab556.
doi: 10.1093/ofid/ofab556. eCollection 2021 Dec.
COVID-19 Outcomes Among US Military Health System Beneficiaries Include Complications Across Multiple Organ Systems and Substantial Functional Impairment
Stephanie A Richard[SUP] 1 2 [/SUP], Simon D Pollett[SUP] 1 2 [/SUP], Charlotte A Lanteri[SUP] 3 [/SUP], Eugene V Millar[SUP] 1 2 [/SUP], Anthony C Fries[SUP] 4 [/SUP], Ryan C Maves[SUP] 1 5 [/SUP], Gregory C Utz[SUP] 1 2 5 [/SUP], Tahaniyat Lalani[SUP] 1 2 6 [/SUP], Alfred Smith[SUP] 6 [/SUP], Rupal M Mody[SUP] 7 [/SUP], Anuradha Ganesan[SUP] 1 2 8 [/SUP], Rhonda E Colombo[SUP] 1 2 9 10 [/SUP], Christopher J Colombo[SUP] 9 10 [/SUP], David A Lindholm[SUP] 11 10 [/SUP], Cristian Madar[SUP] 12 [/SUP], Sharon Chi[SUP] 1 2 12 [/SUP], Nikhil Huprikar[SUP] 8 10 [/SUP], Derek T Larson[SUP] 10 13 [/SUP], Samantha E Bazan[SUP] 14 [/SUP], Caroline English[SUP] 1 2 [/SUP], Edward Parmelee[SUP] 1 2 [/SUP], Katrin Mende[SUP] 1 2 11 [/SUP], Eric D Laing[SUP] 15 [/SUP], Christopher C Broder[SUP] 15 [/SUP], Paul W Blair[SUP] 16 17 [/SUP], Josh G Chenoweth[SUP] 2 17 [/SUP], Mark P Simons[SUP] 1 [/SUP], David R Tribble[SUP] 1 [/SUP], Brian K Agan[SUP] 1 2 [/SUP], Timothy H Burgess[SUP] 1 [/SUP], EPICC COVID-19 Cohort Study Group
Collaborators, Affiliations
Abstract
Background: We evaluated clinical outcomes, functional burden, and complications 1 month after coronavirus disease 2019 (COVID-19) infection in a prospective US Military Health System (MHS) cohort of active duty, retiree, and dependent populations using serial patient-reported outcome surveys and electronic medical record (EMR) review.
Methods: MHS beneficiaries presenting at 9 sites across the United States with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test, a COVID-19-like illness, or a high-risk SARS-CoV-2 exposure were eligible for enrollment. Medical history and clinical outcomes were collected through structured interviews and International Classification of Diseases-based EMR review. Risk factors associated with hospitalization were determined by multivariate logistic regression.
Results: A total of 1202 participants were enrolled. There were 1070 laboratory-confirmed SARS-CoV-2 cases and 132 SARS-CoV-2-negative participants. In the first month post-symptom onset among the SARS-CoV-2-positive cases, there were 212 hospitalizations, 80% requiring oxygen, 20 ICU admissions, and 10 deaths. Risk factors for COVID-19-associated hospitalization included race (increased for Asian, Black, and Hispanic compared with non-Hispanic White), age (age 45-64 and 65+ compared with <45), and obesity (BMI≥30 compared with BMI<30). Over 2% of survey respondents reported the need for supplemental oxygen, and 31% had not returned to normal daily activities at 1 month post-symptom onset.
Conclusions: Older age, reporting Asian, Black, or Hispanic race/ethnicity, and obesity are associated with SARS-CoV-2 hospitalization. A proportion of acute SARS-CoV-2 infections require long-term oxygen therapy; the impact of SARS-CoV-2 infection on short-term functional status was substantial. A significant number of MHS beneficiaries had not yet returned to normal activities by 1 month.
Keywords: COVID-19; burden; outcomes; predictive symptoms; risk.
. 2021 Nov 10;8(12)
fab556.doi: 10.1093/ofid/ofab556. eCollection 2021 Dec.
COVID-19 Outcomes Among US Military Health System Beneficiaries Include Complications Across Multiple Organ Systems and Substantial Functional Impairment
Stephanie A Richard[SUP] 1 2 [/SUP], Simon D Pollett[SUP] 1 2 [/SUP], Charlotte A Lanteri[SUP] 3 [/SUP], Eugene V Millar[SUP] 1 2 [/SUP], Anthony C Fries[SUP] 4 [/SUP], Ryan C Maves[SUP] 1 5 [/SUP], Gregory C Utz[SUP] 1 2 5 [/SUP], Tahaniyat Lalani[SUP] 1 2 6 [/SUP], Alfred Smith[SUP] 6 [/SUP], Rupal M Mody[SUP] 7 [/SUP], Anuradha Ganesan[SUP] 1 2 8 [/SUP], Rhonda E Colombo[SUP] 1 2 9 10 [/SUP], Christopher J Colombo[SUP] 9 10 [/SUP], David A Lindholm[SUP] 11 10 [/SUP], Cristian Madar[SUP] 12 [/SUP], Sharon Chi[SUP] 1 2 12 [/SUP], Nikhil Huprikar[SUP] 8 10 [/SUP], Derek T Larson[SUP] 10 13 [/SUP], Samantha E Bazan[SUP] 14 [/SUP], Caroline English[SUP] 1 2 [/SUP], Edward Parmelee[SUP] 1 2 [/SUP], Katrin Mende[SUP] 1 2 11 [/SUP], Eric D Laing[SUP] 15 [/SUP], Christopher C Broder[SUP] 15 [/SUP], Paul W Blair[SUP] 16 17 [/SUP], Josh G Chenoweth[SUP] 2 17 [/SUP], Mark P Simons[SUP] 1 [/SUP], David R Tribble[SUP] 1 [/SUP], Brian K Agan[SUP] 1 2 [/SUP], Timothy H Burgess[SUP] 1 [/SUP], EPICC COVID-19 Cohort Study Group
Collaborators, Affiliations
- PMID: 34909439
- PMCID: PMC8664684
- DOI: 10.1093/ofid/ofab556
Abstract
Background: We evaluated clinical outcomes, functional burden, and complications 1 month after coronavirus disease 2019 (COVID-19) infection in a prospective US Military Health System (MHS) cohort of active duty, retiree, and dependent populations using serial patient-reported outcome surveys and electronic medical record (EMR) review.
Methods: MHS beneficiaries presenting at 9 sites across the United States with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test, a COVID-19-like illness, or a high-risk SARS-CoV-2 exposure were eligible for enrollment. Medical history and clinical outcomes were collected through structured interviews and International Classification of Diseases-based EMR review. Risk factors associated with hospitalization were determined by multivariate logistic regression.
Results: A total of 1202 participants were enrolled. There were 1070 laboratory-confirmed SARS-CoV-2 cases and 132 SARS-CoV-2-negative participants. In the first month post-symptom onset among the SARS-CoV-2-positive cases, there were 212 hospitalizations, 80% requiring oxygen, 20 ICU admissions, and 10 deaths. Risk factors for COVID-19-associated hospitalization included race (increased for Asian, Black, and Hispanic compared with non-Hispanic White), age (age 45-64 and 65+ compared with <45), and obesity (BMI≥30 compared with BMI<30). Over 2% of survey respondents reported the need for supplemental oxygen, and 31% had not returned to normal daily activities at 1 month post-symptom onset.
Conclusions: Older age, reporting Asian, Black, or Hispanic race/ethnicity, and obesity are associated with SARS-CoV-2 hospitalization. A proportion of acute SARS-CoV-2 infections require long-term oxygen therapy; the impact of SARS-CoV-2 infection on short-term functional status was substantial. A significant number of MHS beneficiaries had not yet returned to normal activities by 1 month.
Keywords: COVID-19; burden; outcomes; predictive symptoms; risk.