# Pre-existing comorbidities and hospitalization for COVID-19 are associated with post-COVID conditions in the U.S. veteran population

## TL;DR

This study finds that U.S. veterans with COPD or who were hospitalized for COVID-19 are more likely to develop long-term post-COVID conditions.

## Contribution

The study identifies specific pre-existing conditions and demographic factors linked to increased risk of post-COVID conditions in veterans.

## Key findings

- Veterans with COPD or who were hospitalized for COVID-19 have higher odds of being diagnosed with post-COVID conditions.
- Unvaccinated or partially vaccinated veterans show significantly higher odds for post-COVID conditions.
- Age, BMI, female sex, Hispanic ethnicity, and location in the Southwestern U.S. increase the risk of post-COVID diagnosis.

## Abstract

Although most survivors of COVID-19 return to their baseline health within two weeks, a notable proportion of individuals continue experiencing symptoms, collectively referred to as Post-COVID Conditions (PCC). To better understand risks associated with contracting PCC, this study aimed to determine whether association exists between pre-existing comorbidities, hospitalization for COVID-19 and the subsequent diagnosis of PCC in US veterans.

This retrospective cohort study collected data from the US Department of Veterans Affairs electronic medical records from September 1, 2021, to July 31, 2023. Participants were limited to those with electronic medical records of a SARS-CoV-2 infection, who received care from the Veterans Affairs hospital system and survived at least 28 days following the infection.

The multivariable logistic regression analysis reveals in hospitalized veterans, chronic obstructive pulmonary disease (COPD) associates with a 21% increase in odds of a PCC diagnosis (adjusted OR 1.21, 95%CI 1.14–1.29; p < 0.001), while in non-hospitalized veterans, chronic kidney disease (OR 1.09 95%CI 1.03–1.15; p = 0.001)) and COPD (OR 1.33, 95%CI 1.27–1.40; p < 0.001) demonstrate an increase in odds of a PCC diagnosis. Additionally, unvaccinated and partially vaccinated veterans exhibit significantly higher odds for PCC (p < 0.001) compared to fully vaccinated veterans in both the hospitalized and non-hospitalized cohorts. Increasing age, increasing BMI, female sex, Hispanic ethnicity, and veterans residing in the Southwestern United States show a significant (p < 0.05) increase in risk for a positive diagnosis of PCC in both groups.

Veterans with pre-existing COPD or those hospitalized at the time of COVID-19 (indicating disease severity) are at higher risk of receiving a PCC diagnosis.

Miller et al. examine the possible association between pre-existing comorbidities and hospitalization with subsequent diagnosis of post-COVID conditions (PCC) among Veterans. Veterans with pre-existing chronic obstructive pulmonary disease or hospitalization during their COVID-19 disease were more likely to be diagnosed with PCC.

Although most COVID-19 survivors return to their baseline health within two weeks, a large number of individuals continue experiencing symptoms, referred to as Long COVID. This study used electronic medical records from the US Department of Veterans Affairs, specifically records from September 1, 2021, to July 31, 2023, to study this disease. Our analysis revealed an increased risk for Long COVID diagnosis in veterans with chronic obstructive pulmonary disease (COPD) and those who hospitalized. Increasing age and body mass index, female sex, Hispanic ethnicity, and veterans residing in the Southwestern United States also showed significantly increased risk for contracting Long COVID. In conclusion, veterans with pre-existing COPD or those who were hospitalized at the time of COVID-19 (indicating disease severity) were more likely to be diagnosed with Long COVID.