Coronavirus disease 2019 in veterans receiving care at veterans health administration facilities

PURPOSE: Veterans represent a significant proportion of the U.S. population (7%), and the impact of the coronavirus disease 2019 (COVID-19) in this group of vulnerable patients has been largely overlooked. This analysis reports COVID-19 patient demographics, infection, mortality, and case-fatality rates in the veteran population. METHODS: This is a cross-sectional analysis using the Veterans Affairs informatics and computing infrastructure tool to assess the veterans' COVID-19 infections at the Veterans Affairs facilities from March 4th to June 23rd, 2020. RESULTS: Of the 10,621,580 veterans in this analysis, 59.7% were ≥65 yo, 92.5% were men, 68.7% were white, and 14.2% were black. Veterans ≥65 yo comprised 52.1% of cases and 89.9% of deaths. The relative mortality and case-fatality rates of black veterans, when compared with white veterans, were 2.83 (CI 2.56–3.14; P < .001) and 0.75 (CI 0.68–0.82; P < .001), respectively. Among the veterans who died from COVID-19, 87.4% had a history of cardiovascular disease, 56.5% had a history of diabetes, and 33.6% were obese. CONCLUSIONS: Elderly veterans (≥65yo) and veterans with a history of cardiovascular disease represent a large proportion of the VA COVID-19 cases and deaths. Black veterans had higher mortality rates but lower case fatality rates when than white veterans.