Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT.
Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT.
Ann Epidemiol. 2022 Jun;70:37-44. doi: 10.1016/j.annepidem.2022.04.003. Epub 2022 Apr 21.
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.
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.
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.
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.
3 (Case-control studies; retrospective cohort study).
尽管退伍军人占美国人口的比例相当大（7%），但这一群体中 COVID-19 疾病的影响却报道不足。为了弥补这一差距，开展了这项研究。
本回顾性研究纳入了 2020 年 3 月 1 日至 2021 年 12 月 31 日期间在退伍军人事务部医院系统内 COVID-19 检测呈阳性并进行了 60 天随访的 419559 名退伍军人。主要结局指标包括 COVID-19 住院、机械通气和病死率的年龄调整发病率和相对发病率。
在患有 COVID-19 疾病的退伍军人队列中，男性占 85.7%，白人退伍军人占 59.1%，年龄在 50-64 岁的占 27.5%，肥胖的占 40.5%。尽管黑人退伍军人的住院发病率相对风险（RR）增加了 63%，但与白人退伍军人参照组相比，住院死亡的风险 RR 相似。与相应的参照组相比，亚洲人、美国印第安人/阿拉斯加原住民、年龄≥65 岁和体重不足的退伍军人机械通气和/或住院死亡的 RR 较高。≥85 岁的退伍军人的死亡率几乎是相应参照组的 5 倍。住院、通气和病死率的月度结果显示，随着时间的推移，呈下降趋势。
与参照组相比，年龄≥65 岁和体重不足的退伍军人的死亡发生率增加。然而，年龄调整数据并未显示黑人退伍军人的死亡发生率高于白人退伍军人。
3（病例对照研究；回顾性队列研究）。
