Case-fatality with coronavirus disease 2019 (COVID-19) in United States Veterans with spinal cord injuries and disorders

Spinal Cord, 2020 · DOI: 10.1038/s41393-020-0529-0 · Published: July 27, 2020

Simple Explanation

This study examines the case fatality rate of COVID-19 in US Veterans with spinal cord injuries and disorders (SCI/D). It compares this rate to that of the overall US Veteran population. The data comes from the VHA SCI/D Registry, which includes over 24,000 Veterans. Operational reports were developed in March 2020 to track COVID-19 infection status. The study found a significantly higher case fatality rate among Veterans with SCI/D compared to those without SCI/D, suggesting increased vulnerability in this population.

Study Duration

March 9, 2020 and June 30, 2020

Participants

17,452 Veterans with SCI/D

Evidence Level

Not specified

Key Findings

1
The case fatality rate of COVID-19 in Veterans with SCI/D was 19% as of June 30, 2020.
2
The SCI/D Veteran case fatality rate with COVID-19 is 2.4 times the rate observed in the non-SCI/D Veteran population.
3
An absolute rate that is 11% greater (95% CI: 5–19%; Z score = 4.8; p < 0.0002).

Research Summary

This study describes the case fatality of COVID-19 infection in Veterans with SCI/D using operational reports from the VHA SCI/D Registry. The case fatality rate in Veterans with SCI/D was significantly higher than in the general Veteran population, even when accounting for similar age distributions. The authors suggest that the higher case fatality rate may be due to the presence of multiple medical comorbidities in the SCI/D population.

Practical Implications

Enhanced Protection Measures

The findings support efforts to minimize the risk of COVID-19 outbreaks in institutional settings caring for individuals with SCI/D.

Increased Vigilance

Individuals with SCI/D in all settings should be strongly encouraged to take actions to minimize their chance of acquiring COVID-19.

Risk Awareness

These data provide preliminary evidence that individuals with SCI/D have higher case fatality and infection severity with COVID-19 than the general population.

Study Limitations

1
Individuals with asymptomatic infections are unaccounted for.
2
Individuals with minimal symptoms may not have received testing.
3
Mild symptoms from COVID-19 in an individual with SCI/D could be misattributed to other medical conditions.

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