Years After Pandemic End, Severe COVID-19 Threatens Older Veterans Because of Risk Factors Most older veterans have one or more risk factors for severe COVID-19, but a high percentage of those have not kept up with their vaccinations, according to a new study looking at the effects of “stacking” risk factors for SARS-CoV-2 cases leading to hospitalization or death. The authors urged that combinations of risk factors be used to prioritize veterans and other adults for vaccination to help decrease the impact of severe COVID-19. 9 4 by Brenda L. Mooney PROVIDENCE, RI—In a recent study conducted with nearly 400,000 VHA patients after the height of the COVID-19 pandemic, nearly all—97.3%—of the vet- eran co-hort were found to have two or more risk factors for severe infection with SARS-CoV-2. “This is reflective of the Veterans Affairs population, which generally exhibits a higher prevalence of underly- ing conditions compared with the non-veteran U.S. pop- ulation,” wrote the authors from the VA Providence, RI, Healthcare System and the University of Rhode Island College of Pharmacy. The researchers also pointed out that multimorbid- ity has increased steadily in the general U.S. population over the last 20 years, explaining that [12, 13] data from the Behavioral Risk Factor Surveillance System demon- strated that, in 2023, more than three-quarters (76.4%) of U.S. adults had one or more chronic conditions, and more than half (51.4%) had two or more conditions. “Although the prevalence of chronic conditions increases with age, in 2023 an estimated 27.1% of indi- viduals aged 18-34, 52.7% of those aged 35-65, and 78.8% of adults ≥ 65 years had multiple chronic condi- tions,” they explained in Infectious Diseases & Therapy. “Given the increased risk of severe COVID-19 with mul- timorbidity observed in our study and the steady rise in the prevalence of chronic conditions, it is increasingly important that patients and providers follow recommen- dations for vaccination and early antiviral treatment to mitigate the risk of severe COVID-19 outcomes, espe- cially among those with multiple chronic conditions.”1 In other words, the study authors were making the point that, while the COVID-19 pandemic emergency officially ended in 2023, SARS-CoV-2 infection remains dangerous for patients – including many U.S. veterans— with risk factors for progression to severe outcomes. Their recent study noted that several risk factors for progression to severe COVID-19 have been identi- fied, but that it remained unknown whether multiple concomi-tant risk factors—i.e., risk-stacking—further increased risk. The investigators sought to identify outpa- tient populations at the highest risk for severe COVID- 19 using risk factor stacking.
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