Pre-existing comorbidities and hospitalization for COVID-19 are associated with post-COVID conditions in the US Veteran population

Abstract: Introduction: 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. Methods: 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. Results: 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. Conclusions: 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.

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