Infection rate, mortality and characteristics of veterans with amyotrophic lateral sclerosis with COVID-19

Muscle & Nerve, 2021 · DOI: 10.1002/mus.27373 · Published: July 9, 2021

Simple Explanation

This study examined the prevalence and impact of COVID-19 in veterans with ALS using data from the Veteran Administration Informatics and Computing Infrastructure (VINCI) and the Veteran Health Administration (VHA) Spinal Cord Injury/Disorders (SCI/D) Registry. The study found that veterans with ALS were significantly more likely to die within 30 days of a COVID-19 diagnosis compared to the overall veteran population. Obstructive sleep apnea (OSA) was identified as a factor associated with an increased risk of contracting COVID-19 in this population.

Study Duration

January 1st, 2020 to January 31st, 2021

Participants

4086 Veterans with ALS

Evidence Level

Not specified

Key Findings

1
Veterans with ALS were 3.0 times more likely to die within 30 days of a COVID-19 diagnosis compared to the overall veteran population (CI: 1.9–4.9, p < .001).
2
The ALS COVID-19 case fatality rate (CFR) was estimated to be 20.0% (CI: 11.1%–31.8%) based on VHA-SCI/D Registry data.
3
Obstructive sleep apnea (OSA) was associated with an increased chance of contracting COVID-19 (OR = 2.2; CI:1.2–4.0; p = .012).

Research Summary

This letter describes the COVID-19 prevalence and case fatality rate (CFR), as reported by aggregate summaries from VINCI, as well as the characteristics and outcomes, as reported by the VHA-SCI/D Registry, for COVID-19-positive veterans with ALS. Compared to the overall veteran population, veterans with ALS were 3.0 times more likely to die within 30 days of COVID-19 diagnosis This report demonstrates an increased risk of COVID-19 related death in individuals with ALS. This finding, although limited, should be taken into consideration by relevant agencies during COVID-19 vaccine prioritization decision making processes.

Practical Implications

Vaccine Prioritization

Relevant agencies should consider the increased risk of COVID-19 related death in individuals with ALS during COVID-19 vaccine prioritization decision making processes.

Risk Assessment

Obstructive sleep apnea (OSA) should be considered as a risk factor for contracting COVID-19 in patients with ALS.

Prognosis Awareness

Healthcare providers should be aware of the exceptionally poor COVID-19 prognosis for patients with ALS.

Study Limitations

1
The 30-day mortality approach may underestimate death due to COVID-19.
2
Outcomes more granular than 30-day mortality for the general VA population cannot be obtained without further regulatory approval.
3
The study acknowledges limitations in identifying specific determinants of respiratory compromise beyond OSA.

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