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Health Services Research & Development

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Veterans with Spinal Cord Injury and Disorder at Increased Risk of Death from COVID-19

March 5, 2021


Takeaway: Veterans with spinal cord injury and disorder (SCI/D) and COVID-19 were 2.5 times more likely to die than those with COVID-19 but without SCI/D. Individuals with SCI/D should be strongly encouraged to take actions to minimize their chance of acquiring COVID-19. This work has been cited in the latest VA guidance for prioritization of COVID-19 vaccinations for outpatient SCI Veterans.

Veterans with SCI/D have unique medical concerns that can increase their risk of mortality from COVID-19 infection. VA’s SCI/D National Program Office oversees healthcare services received by more than 24,000 Veterans with SCI/D at 170 medical centers and more than 1,000 outpatient care sites. To support outreach and prevention activities in response to the current COVID-19 pandemic, the National Program Office developed operational reports showing COVID-19 infection status among Veterans with SCI/D. Additional data (i.e., demographics, comorbidities, and geographic setting) were used to determine an infection risk category and severity risk category for each SCI/D Veteran. These reports were developed in March 2020 and made available to VA SCI/D Centers on April 7, 2020. Using these reports, investigators conducting this retrospective comparative analysis sought to describe case fatality of COVID-19 infection among Veterans with SCI/D. 

Findings showed that between March 9, 2020 and June 30, 2020, COVID-19 was identified in 140 of 17,452 Veterans with SCI/D. During that same period, the case fatality rate for Veterans with SCI/D was 19% compared to 8% for Veterans without SCI/D. Thus, Veterans with SCI/D and COVID-19 were 2.5 times more likely to die than those with COVID-19 without SCI/D.

Impacts

This work has been cited in the latest VA guidance for prioritization of COVID-19 vaccinations for outpatient SCI Veterans [if we don’t have a link or something, listing a number really doesn’t add anything I don’t think]. The VA SCI/D population includes a considerable number of older Veterans with multiple medical conditions which increase their risk of severe COVID-19 infection. These findings provide preliminary evidence that individuals with SCI/D in all settings, including institutional settings, should be strongly encouraged to take actions to minimize their chance of acquiring COVID-19.

Partners

This project was a joint effort between VA clinical staff in the spinal cord injury/disorder (SCI/D) units at the Puget Sound and St. Louis VA Medical Centers, HSR&D’s Center of Innovation for Complex Chronic Healthcare (CINCCH), and VA’s SCI/D National Program Office.

Publications

Burns S, Eberhart A, Sippel J, Wilson G, and Evans C. Case-fatality with coronavirus disease 2019 (COVID-19) in United States Veterans with spinal cord injuries and disorders. Spinal Cord. September 2020;58(9):1040-1041.


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