COVID-19 Outcomes Among US Military Health System Beneficiaries Include Complications Across Multiple Organ Systems and Substantial Functional Impairment-Reference-Cited by-同舟云学术

COVID-19 Outcomes Among US Military Health System Beneficiaries Include Complications Across Multiple Organ Systems and Substantial Functional Impairment

Published:2021-11-10 Issue:12 Volume:8 Page:
ISSN:2328-8957
Container-title:Open Forum Infectious Diseases
language:en
Short-container-title:

Author:

Richard Stephanie A¹²^ORCID,Pollett Simon D¹²,Lanteri Charlotte A³,Millar Eugene V¹²,Fries Anthony C⁴,Maves Ryan C¹⁵,Utz Gregory C¹²⁵,Lalani Tahaniyat¹²⁶^ORCID,Smith Alfred⁶,Mody Rupal M⁷,Ganesan Anuradha¹²⁸,Colombo Rhonda E¹²⁹¹⁰,Colombo Christopher J⁹¹⁰,Lindholm David A¹¹¹⁰,Madar Cristian¹²,Chi Sharon¹²¹²,Huprikar Nikhil⁸¹⁰,Larson Derek T¹⁰¹³,Bazan Samantha E¹⁴,English Caroline¹²,Parmelee Edward¹²,Mende Katrin¹²¹¹,Laing Eric D¹⁵,Broder Christopher C¹⁵,Blair Paul W¹⁶¹⁷,Chenoweth Josh G²¹⁷,Simons Mark P¹,Tribble David R¹,Agan Brian K¹²^ORCID,Burgess Timothy H¹,Cowden J,Lindholm D,Markelz A,Mende K,Merritt T,Walter R,Wellington T,Bazan S,Dimascio-Johnson N,Ewers E,Gallagher K,Larson D,Odom M,Rutt A,Blair P,Chenoweth J G,Clark D,Chambers S,Colombo C,Colombo R,Conlon C,Everson K,Faestel P,Ferguson T,Gordon L,Grogan S,Lis S,Mount C,Musfeldt D,Odineal D,Sainato R,Schofield C,Skinner C,Stein M,Switzer M,Timlin M,Wood S,Carpenter R,Kim L,Kronmann K,Lalani T,Lee T,Smith A,Warkentien T,Arnold J,Berjohn C,Cammarata S,Husain S,Lane A,Maves R,Parrish J,Utz G,Chi S,Filan E,Fong K,Horseman T,Jones M,Kanis A,Kayatani A,Londeree W,Madar C,Masel J,McMahon M,Murphy G,Ngauy V,Schmidt P,Schoenman E,Uyehara C,Villacorta Lyew R,Agan B,Broder C,Burgess T,Byrne C,Coles C,English C,Hickey P,Laing E,Livezey J,Malloy A,Oliver T,Parmelee E,Pollett S,Rajnik M,Richard S,Rozman J,Sanchez M,Scher A,Simons M,L Snow A,Tribble D,Fries A,Farmer A,Barton B,Hostler D,Maldonado C,Musich T,Radcliffe R,Swain M,Banda M,Davis B,Hunter T,Ikpekpe-Magege O,Kemp S,Mody R,Wiggins M,Ganesan A,Gunasekera D,Huprikar N,

Affiliation:

1. Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA

2. Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA

3. Walter Reed Army Institute of Research, Silver Spring, Maryland, USA

4. US Air Force School of Aerospace Medicine, Wright-Patterson, Ohio, USA

5. Naval Medical Center San Diego, San Diego, California, USA

6. Naval Medical Center Portsmouth, Portsmouth, Virginia, USA

7. William Beaumont Army Medical Center, El Paso, Texas, USA

8. Walter Reed National Military Medical Center, Bethesda, Maryland, USA

9. Madigan Army Medical Center, Joint Base Lewis McChord, Washington, USA

10. Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA

11. Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA

12. Tripler Army Medical Center, Honolulu, Hawaii, USA

13. Fort Belvoir Community Hospital, Fort Belvoir, Virginia, USA

14. Carl R. Darnall Army Medical Center, Fort Hood, Texas, USA

15. Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA

16. Department of Pathology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA

17. Austere environments Consortium for Enhanced Sepsis Outcomes, Henry M. Jackson Foundation, Bethesda, Maryland, USA

Abstract

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.

Funder

National Institute of Allergy and Infectious Diseases

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Oncology

Link

https://academic.oup.com/ofid/advance-article-pdf/doi/10.1093/ofid/ofab556/41125167/ofab556.pdf

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