Ross Jennifer M, Sugimoto Jonathan D, Timmons Andrew, Adams Jonathan, Deardoff Katrina, Korpak Anna, Liu Cindy, Moore Kathryn, Wilson Deanna, Bedimo Roger, Chang Kyong-Mi, Cho Kelly, Crothers Kristina, Garshick Eric, Gaziano J Michael, Holodniy Mark, Hunt Christine M, Isaacs Stuart N, Le Elizabeth, Jones Barbara E, Shah Javeed A, Smith Nicholas L, Lee Jennifer S
VA Puget Sound Health Care System, Seattle, Washington, USA.
Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA.
Open Forum Infect Dis. 2023 Jun 27;10(7):ofad330. doi: 10.1093/ofid/ofad330. eCollection 2023 Jul.
Over 870 000 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have occurred among Veterans Health Administration users, and 24 000 have resulted in death. We examined early outcomes of SARS-CoV-2 infection in hospitalized veterans.
In an ongoing, prospective cohort study, we enrolled veterans age ≥18 tested for SARS-CoV-2 and hospitalized at 15 Department of Veterans Affairs medical centers between February 2021 and June 2022. We estimated adjusted odds ratios (aORs), adjusted incidence rate ratios (aIRRs), and adjusted hazard ratios (aHRs) for maximum illness severity within 30 days of study entry (defined using the 4-category VA Severity Index for coronavirus disease 2019 [COVID-19]), as well as length of hospitalization and rehospitalization within 60 days, in relationship with demographic characteristics, Charlson comorbidity index (CCI), COVID-19 vaccination, and calendar period of enrollment.
The 542 participants included 329 (61%) who completed a primary vaccine series (with or without booster; "vaccinated"), 292 (54%) enrolled as SARS-CoV-2-positive, and 503 (93%) men, with a mean age of 64.4 years. High CCI scores (≥5) occurred in 61 (44%) vaccinated and 29 (19%) unvaccinated SARS-CoV-2-positive participants. Severe illness or death occurred in 29 (21%; 6% died) vaccinated and 31 (20%; 2% died) unvaccinated SARS-CoV-2-positive participants. SARS-CoV-2-positive inpatients per unit increase in CCI had greater multivariable-adjusted odds of severe illness (aOR, 1.21; 95% CI, 1.01-1.45), more hospitalization days (aIRR, 1.06; 95% CI, 1.03-1.10), and rehospitalization (aHR, 1.07; 95% CI, 1.01-1.12).
In a cohort of hospitalized US veterans with SARS-CoV-2 infection, those with a higher CCI had more severe COVID-19 illness, more hospital days, and rehospitalization, after adjusting for vaccination status, age, sex, and calendar period.
退伍军人健康管理局的使用者中已发生超过87万例严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染，其中2.4万例导致死亡。我们研究了住院退伍军人SARS-CoV-2感染的早期结局。
在一项正在进行的前瞻性队列研究中，我们纳入了年龄≥18岁、接受SARS-CoV-2检测并于2021年2月至2022年6月期间在15家退伍军人事务部医疗中心住院的退伍军人。我们估计了研究入组后30天内最大疾病严重程度（使用4分类的退伍军人事务部2019冠状病毒病[COVID-19]严重程度指数定义）、60天内住院时间和再次住院的调整优势比（aOR）、调整发病率比（aIRR）和调整风险比（aHR），与人口统计学特征、Charlson合并症指数（CCI）、COVID-19疫苗接种情况和入组日历时间的关系。
542名参与者中，329名（61%）完成了初级疫苗系列接种（有或无加强针；“接种疫苗”），292名（54%）以SARS-CoV-2阳性入组，503名（93%）为男性，平均年龄64.4岁。61名（44%）接种疫苗和29名（19%）未接种疫苗的SARS-CoV-2阳性参与者的CCI评分较高（≥5）。29名（21%；6%死亡）接种疫苗和31名（20%；2%死亡）未接种疫苗的SARS-CoV-2阳性参与者发生了严重疾病或死亡。CCI每增加一个单位，SARS-CoV-2阳性住院患者发生严重疾病的多变量调整优势比更高（aOR，1.21；95%CI，1.01-1.45），住院天数更多（aIRR，1.06；95%CI，1.03-1.10），再次住院的风险更高（aHR，1.07；95%CI，1.01-1.12）。
在一组感染SARS-CoV-2的美国住院退伍军人中，在调整疫苗接种状态、年龄、性别和日历时间后，CCI较高的患者COVID-19病情更严重，住院天数更多，且再次住院。
