Table 2. Trends over time in the associations (AORs*) of sociodemographic characteristics and comorbidity burden with risk of SARS-CoV-2 infection in a cohort of 9.1 million VA enrollees from February 2020 to March 2021.
| AORs* for SARS-CoV-2 infection (95% CI) | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Entire period: February 2020 to March 2021 N = 9,127,673 |
February to March 2020 N = 9,127,673 |
April 2020 N = 9,090,196 |
May 2020 N = 9,053,082 |
June 2020 N = 9,022,051 |
July 2020 N = 8,990,833 |
August 2020 N = 8,948,674 |
September 2020 N = 8,913,864 |
October 2020 N = 8,881,573 |
November 2020 N = 8,844,680 |
December 2020 N = 8,804,424 |
January 2021 N = 8,744,388 |
February 2021 N = 8,671,916 |
March 2021 N = 8,630,283 |
|
| Sex | ||||||||||||||
| Female | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| Male | 0.88 (0.87 to 0.90) |
1.20 (1.04 to 1.39) |
0.91 (0.84 to 0.98) |
0.94 (0.85 to 1.04) |
0.97 (0.90 to 1.05) |
0.89 (0.85 to 0.94) |
0.92 (0.86 to 0.98) |
0.94 (0.87 to 1.02) |
0.94 (0.88 to 0.99) |
0.87 (0.83 to 0.90) |
0.85 (0.83 to 0.88) |
0.89 (0.86 to 0.92) |
0.86 (0.81 to 0.90) |
0.90 (0.84 to 0.96) |
| Age (years) | ||||||||||||||
| 25 | 0.77 (0.76 to 0.79) |
0.62 (0.49 to 0.79) |
0.81 (0.70 to 0.94) |
0.94 (0.79 to 1.12) |
1.25 (1.12 to 1.39) |
0.96 (0.89 to 1.03) |
0.87 (0.78 to 0.97) |
0.76 (0.67 to 0.87) |
0.69 (0.62 to 0.76) |
0.72 (0.68 to 0.77) |
0.75 (0.71 to 0.79) |
0.72 (0.68 to 0.76) |
0.69 (0.63 to 0.76) |
0.71 (0.64 to 0.79) |
| 35 | 0.92 (0.91 to 0.92) |
0.84 (0.76 to 0.93) |
0.92 (0.86 to 0.97) |
0.96 (0.89 to 1.03) |
1.13 (1.08 to 1.18) |
1.01 (0.98 to 1.04) |
0.95 (0.91 to 1.00) |
0.91 (0.86 to 0.96) |
0.87 (0.84 to 0.91) |
0.89 (0.87 to 0.91) |
0.91 (0.89 to 0.93) |
0.89 (0.87 to 0.91) |
0.87 (0.84 to 0.90) |
0.88 (0.84 to 0.92) |
| 45 (reference) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| 55 | 0.89 (0.88 to 0.89) |
0.86 (0.80 to 0.93) |
0.99 (0.94 to 1.04) |
1.09 (1.03 to 1.16) |
0.83 (0.80 to 0.87) |
0.85 (0.82 to 0.88) |
0.93 (0.89 to 0.97) |
0.89 (0.85 to 0.93) |
0.88 (0.85 to 0.91) |
0.86 (0.85 to 0.88) |
0.87 (0.86 to 0.89) |
0.90 (0.88 to 0.92) |
0.94 (0.91 to 0.97) |
0.90 (0.86 to 0.93) |
| 65 | 0.71 (0.70 to 0.73) |
0.65 (0.57 to 0.75) |
0.86 (0.79 to 0.94) |
1.01 (0.91 to 1.13) |
0.65 (0.60 to 0.71) |
0.66 (0.62 to 0.69) |
0.79 (0.73 to 0.85) |
0.73 (0.68 to 0.80) |
0.71 (0.67 to 0.75) |
0.68 (0.65 to 0.71) |
0.70 (0.68 to 0.72) |
0.75 (0.72 to 0.77) |
0.80 (0.76 to 0.85) |
0.68 (0.64 to 0.73) |
| 75 | 0.64 (0.63 to 0.65) |
0.57 (0.51 to 0.65) |
0.75 (0.70 to 0.82) |
0.80 (0.73 to 0.88) |
0.54 (0.50 to 0.58) |
0.54 (0.52 to 0.57) |
0.70 (0.65 to 0.74) |
0.68 (0.64 to 0.73) |
0.66 (0.62 to 0.69) |
0.62 (0.60 to 0.64) |
0.65 (0.63 to 0.67) |
0.71 (0.69 to 0.73) |
0.76 (0.73 to 0.80) |
0.54 (0.51 to 0.58) |
| 85 | 0.58 (0.57 to 0.59) |
0.50 (0.43 to 0.58) |
0.91 (0.84 to 0.99) |
1.03 (0.93 to 1.13) |
0.56 (0.52 to 0.61) |
0.52 (0.49 to 0.55) |
0.67 (0.62 to 0.73) |
0.66 (0.61 to 0.72) |
0.60 (0.57 to 0.64) |
0.57 (0.55 to 0.60) |
0.62 (0.60 to 0.65) |
0.66 (0.64 to 0.69) |
0.71 (0.67 to 0.75) |
0.47 (0.43 to 0.51) |
| Race | ||||||||||||||
| White | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| Black | 1.39 (1.37 to 1.41) |
5.10 (4.65 to 5.59) |
3.13 (2.97 to 3.31) |
2.55 (2.39 to 2.73) |
1.96 (1.85 to 2.07) |
1.91 (1.84 to 1.98) |
1.75 (1.66 to 1.84) |
1.33 (1.25 to 1.41) |
1.06 (1.01 to 1.11) |
1.03 (1.00 to 1.07) |
1.15 (1.12 to 1.18) |
1.26 (1.23 to 1.29) |
1.30 (1.25 to 1.35) |
1.16 (1.10 to 1.23) |
| Asian | 0.84 (0.80 to 0.87) |
1.78 (1.21 to 2.63) |
1.07 (0.81 to 1.39) |
0.96 (0.69 to 1.34) |
0.70 (0.56 to 0.88) |
0.87 (0.75 to 1.02) |
0.90 (0.72 to 1.13) |
0.99 (0.78 to 1.26) |
0.78 (0.64 to 0.96) |
0.75 (0.67 to 0.85) |
0.82 (0.75 to 0.89) |
0.84 (0.76 to 0.93) |
0.89 (0.77 to 1.03) |
0.74 (0.59 to 0.92) |
| AI/AN | 0.93 (0.89 to 0.98) |
1.13 (0.67 to 1.92) |
1.40 (1.07 to 1.83) |
1.54 (1.16 to 2.05) |
1.21 (0.98 to 1.48) |
0.94 (0.80 to 1.11) |
0.89 (0.71 to 1.11) |
1.00 (0.79 to 1.25) |
0.99 (0.84 to 1.17) |
0.93 (0.84 to 1.04) |
0.88 (0.80 to 0.97) |
0.89 (0.80 to 0.99) |
0.97 (0.83 to 1.13) |
0.66 (0.51 to 0.85) |
| PI/NH | 0.98 (0.93 to 1.02) |
0.99 (0.57 to 1.70) |
1.31 (1.01 to 1.71) |
1.34 (1.00 to 1.81) |
0.95 (0.75 to 1.19) |
0.95 (0.81 to 1.11) |
1.22 (1.00 to 1.49) |
1.12 (0.89 to 1.41) |
0.97 (0.81 to 1.17) |
0.97 (0.87 to 1.09) |
0.88 (0.80 to 0.97) |
0.98 (0.89 to 1.08) |
1.06 (0.91 to 1.23) |
0.78 (0.62 to 1.00) |
| Missing/unknown/refused | 0.82 (0.81 to 0.84) |
1.27 (1.05 to 1.55) |
1.05 (0.93 to 1.17) |
1.10 (0.96 to 1.25) |
0.84 (0.77 to 0.93) |
0.89 (0.83 to 0.95) |
0.85 (0.77 to 0.93) |
0.87 (0.78 to 0.96) |
0.79 (0.73 to 0.86) |
0.81 (0.77 to 0.85) |
0.81 (0.77 to 0.84) |
0.80 (0.76 to 0.84) |
0.78 (0.73 to 0.84) |
0.77 (0.70 to 0.85) |
| Ethnicity | ||||||||||||||
| Non-Hispanic | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| Hispanic | 1.64 (1.62 to 1.67) |
1.57 (1.37 to 1.81) |
1.27 (1.16 to 1.38) |
1.55 (1.40 to 1.73) |
2.39 (2.24 to 2.56) |
2.55 (2.43 to 2.67) |
2.10 (1.96 to 2.25) |
1.57 (1.44 to 1.71) |
1.57 (1.47 to 1.67) |
1.46 (1.40 to 1.52) |
1.53 (1.48 to 1.58) |
1.49 (1.43 to 1.54) |
1.38 (1.30 to 1.46) |
1.48 (1.37 to 1.60) |
| Missing/unknown/refused | 0.40 (0.39 to 0.41) |
0.38 (0.29 to 0.50) |
0.37 (0.32 to 0.43) |
0.32 (0.27 to 0.39) |
0.44 (0.38 to 0.50) |
0.41 (0.37 to 0.45) |
0.39 (0.34 to 0.45) |
0.36 (0.31 to 0.41) |
0.38 (0.34 to 0.42) |
0.37 (0.34 to 0.39) |
0.41 (0.39 to 0.43) |
0.43 (0.40 to 0.46) |
0.42 (0.38 to 0.46) |
0.40 (0.35 to 0.46) |
| US Federal Region † | ||||||||||||||
| 1 | 0.89 (0.86 to 0.91) |
2.48 (1.97 to 3.12) |
6.04 (5.50 to 6.62) |
2.89 (2.56 to 3.25) |
0.57 (0.49 to 0.66) |
0.17 (0.15 to 0.21) |
0.21 (0.18 to 0.26) |
0.28 (0.23 to 0.35) |
0.46 (0.40 to 0.52) |
1.07 (1.00 to 1.15) |
0.97 (0.92 to 1.02) |
0.86 (0.81 to 0.91) |
0.92 (0.86 to 1.00) |
1.12 (1.00 to 1.24) |
| 2 | 0.72 (0.71 to 0.74) |
5.81 (5.08 to 6.65) |
5.14 (4.75 to 5.56) |
1.85 (1.66 to 2.05) |
0.33 (0.29 to 0.38) |
0.18 (0.16 to 0.20) |
0.22 (0.19 to 0.25) |
0.32 (0.28 to 0.37) |
0.44 (0.39 to 0.49) |
0.79 (0.74 to 0.84) |
0.69 (0.65 to 0.72) |
0.64 (0.61 to 0.68) |
0.72 (0.67 to 0.77) |
1.10 (1.01 to 1.20) |
| 3 | 0.83 (0.81 to 0.84) |
1.22 (1.03 to 1.46) |
1.84 (1.68 to 2.01) |
1.59 (1.44 to 1.76) |
0.47 (0.42 to 0.51) |
0.33 (0.30 to 0.35) |
0.44 (0.40 to 0.48) |
0.52 (0.47 to 0.57) |
0.69 (0.64 to 0.74) |
1.14 (1.09 to 1.19) |
1.01 (0.97 to 1.05) |
0.81 (0.78 to 0.84) |
0.85 (0.80 to 0.90) |
1.06 (0.99 to 1.14) |
| 4 (reference) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| 5 | 1.13 (1.11 to 1.15) |
2.50 (2.17 to 2.88) |
2.25 (2.07 to 2.45) |
1.86 (1.70 to 2.03) |
0.48 (0.44 to 0.53) |
0.40 (0.38 to 0.43) |
0.57 (0.53 to 0.62) |
0.87 (0.81 to 0.93) |
1.79 (1.70 to 1.89) |
2.72 (2.63 to 2.82) |
1.23 (1.20 to 1.27) |
0.73 (0.71 to 0.76) |
0.75 (0.71 to 0.79) |
1.07 (1.01 to 1.15) |
| 6 | 1.13 (1.12 to 1.15) |
2.76 (2.41 to 3.17) |
1.30 (1.18 to 1.43) |
1.00 (0.89 to 1.11) |
1.30 (1.22 to 1.38) |
1.23 (1.18 to 1.28) |
0.93 (0.88 to 0.99) |
0.99 (0.92 to 1.06) |
1.33 (1.26 to 1.41) |
1.50 (1.44 to 1.56) |
1.10 (1.07 to 1.13) |
1.04 (1.01 to 1.07) |
0.86 (0.81 to 0.90) |
0.85 (0.79 to 0.92) |
| 7 | 1.42 (1.39 to 1.44) |
1.22 (0.93 to 1.62) |
1.46 (1.26 to 1.68) |
1.56 (1.35 to 1.79) |
0.54 (0.47 to 0.62) |
0.60 (0.55 to 0.66) |
1.12 (1.03 to 1.22) |
1.92 (1.77 to 2.08) |
2.38 (2.23 to 2.53) |
3.37 (3.23 to 3.52) |
1.44 (1.38 to 1.50) |
0.93 (0.88 to 0.97) |
0.93 (0.87 to 1.00) |
1.00 (0.91 to 1.11) |
| 8 | 1.17 (1.14 to 1.19) |
2.65 (2.06 to 3.42) |
2.04 (1.76 to 2.37) |
1.67 (1.43 to 1.97) |
0.48 (0.40 to 0.56) |
0.36 (0.32 to 0.41) |
0.53 (0.46 to 0.60) |
1.23 (1.11 to 1.37) |
2.39 (2.22 to 2.56) |
3.10 (2.95 to 3.25) |
1.18 (1.12 to 1.24) |
0.61 (0.57 to 0.65) |
0.68 (0.62 to 0.74) |
1.03 (0.92 to 1.15) |
| 9 | 1.23 (1.21 to 1.24) |
1.36 (1.12 to 1.64) |
0.99 (0.88 to 1.12) |
0.90 (0.79 to 1.02) |
1.31 (1.22 to 1.40) |
0.93 (0.88 to 0.98) |
0.71 (0.66 to 0.77) |
0.68 (0.62 to 0.74) |
0.69 (0.64 to 0.75) |
1.37 (1.31 to 1.43) |
1.73 (1.68 to 1.78) |
1.34 (1.30 to 1.38) |
1.08 (1.03 to 1.14) |
0.89 (0.82 to 0.96) |
| 10 | 0.68 (0.66 to 0.70) |
1.38 (1.00 to 1.89) |
1.16 (0.97 to 1.40) |
0.79 (0.64 to 0.98) |
0.44 (0.37 to 0.52) |
0.48 (0.43 to 0.53) |
0.60 (0.53 to 0.68) |
0.62 (0.54 to 0.71) |
0.89 (0.81 to 0.99) |
1.23 (1.15 to 1.31) |
0.73 (0.68 to 0.77) |
0.43 (0.40 to 0.47) |
0.56 (0.51 to 0.62) |
0.80 (0.71 to 0.90) |
| Urban versus rural | ||||||||||||||
| Rural | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| Urban | 1.01 (1.00 to 1.02) |
2.02 (1.83 to 2.22) |
1.95 (1.85 to 2.06) |
1.60 (1.50 to 1.70) |
1.39 (1.32 to 1.45) |
1.23 (1.20 to 1.28) |
0.93 (0.89 to 0.97) |
0.85 (0.81 to 0.89) |
0.88 (0.85 to 0.91) |
0.96 (0.94 to 0.98) |
0.94 (0.92 to 0.96) |
0.96 (0.94 to 0.98) |
0.96 (0.93 to 0.99) |
0.98 (0.94 to 1.02) |
| BMI (kg/m2) | ||||||||||||||
| 15 | ||||||||||||||
| 20 | 0.99 (0.97 to 1.00) |
1.12 (0.96 to 1.31) |
1.40 (1.29 to 1.52) |
1.49 (1.35 to 1.63) |
1.18 (1.08 to 1.30) |
0.97 (0.90 to 1.04) |
0.99 (0.90 to 1.08) |
1.03 (0.93 to 1.14) |
0.94 (0.87 to 1.02) |
0.88 (0.83 to 0.92) |
0.98 (0.94 to 1.02) |
1.01 (0.97 to 1.06) |
1.04 (0.97 to 1.11) |
1.15 (1.05 to 1.26) |
| 25 (reference) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| 30 | 1.23 (1.21 to 1.25) |
1.21 (1.06 to 1.37) |
1.14 (1.06 to 1.23) |
1.10 (1.01 to 1.20) |
1.24 (1.15 to 1.34) |
1.19 (1.13 to 1.25) |
1.14 (1.06 to 1.22) |
1.17 (1.09 to 1.26) |
1.28 (1.21 to 1.36) |
1.22 (1.17 to 1.26) |
1.24 (1.20 to 1.28) |
1.24 (1.20 to 1.28) |
1.22 (1.16 to 1.28) |
1.27 (1.19 to 1.36) |
| 35 | 1.38 (1.36 to 1.39) |
1.36 (1.21 to 1.52) |
1.26 (1.18 to 1.34) |
1.14 (1.05 to 1.24) |
1.28 (1.20 to 1.37) |
1.32 (1.26 to 1.38) |
1.36 (1.28 to 1.44) |
1.28 (1.20 to 1.36) |
1.41 (1.34 to 1.48) |
1.39 (1.35 to 1.44) |
1.39 (1.35 to 1.43) |
1.37 (1.33 to 1.41) |
1.36 (1.30 to 1.42) |
1.43 (1.35 to 1.52) |
| 40 | 1.51 (1.49 to 1.53) |
1.41 (1.26 to 1.58) |
1.39 (1.30 to 1.48) |
1.22 (1.12 to 1.32) |
1.39 (1.30 to 1.49) |
1.46 (1.40 to 1.53) |
1.45 (1.37 to 1.54) |
1.38 (1.29 to 1.47) |
1.54 (1.47 to 1.62) |
1.52 (1.47 to 1.57) |
1.52 (1.48 to 1.57) |
1.50 (1.46 to 1.55) |
1.50 (1.44 to 1.57) |
1.59 (1.50 to 1.69) |
| CCI | ||||||||||||||
| 0 to 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| 2 to 3 | 2.16 (2.14 to 2.19) |
2.25 (2.01 to 2.52) |
2.24 (2.10 to 2.40) |
2.28 (2.10 to 2.47) |
1.98 (1.85 to 2.11) |
2.14 (2.05 to 2.23) |
2.01 (1.90 to 2.13) |
2.18 (2.05 to 2.32) |
2.12 (2.02 to 2.22) |
2.09 (2.03 to 2.15) |
2.20 (2.14 to 2.25) |
2.25 (2.19 to 2.31) |
2.10 (2.02 to 2.18) |
2.00 (1.89 to 2.11) |
| 4 to 5 | 2.56 (2.52 to 2.60) |
2.80 (2.45 to 3.20) |
3.04 (2.82 to 3.28) |
3.10 (2.83 to 3.40) |
2.61 (2.41 to 2.82) |
2.42 (2.29 to 2.55) |
2.53 (2.37 to 2.71) |
2.61 (2.42 to 2.82) |
2.40 (2.27 to 2.54) |
2.49 (2.40 to 2.58) |
2.62 (2.54 to 2.70) |
2.67 (2.59 to 2.76) |
2.38 (2.27 to 2.50) |
2.11 (1.97 to 2.26) |
| ≥6 | 3.16 (3.12 to 3.21) |
4.53 (4.03 to 5.10) |
4.68 (4.37 to 5.01) |
4.34 (3.99 to 4.72) |
3.37 (3.13 to 3.62) |
3.08 (2.93 to 3.25) |
3.16 (2.96 to 3.38) |
3.33 (3.10 to 3.58) |
3.22 (3.06 to 3.40) |
3.02 (2.92 to 3.13) |
3.31 (3.21 to 3.41) |
3.20 (3.10 to 3.30) |
2.95 (2.81 to 3.09) |
2.51 (2.35 to 2.69) |
* Adjusted for sex, age (modeled as restricted cubic splines with 5 knots at ages 30, 49, 64, 73, and 88 years), race, ethnicity, geographical region, urban/rural location, BMI (modeled as restricted cubic splines with 5 knots at BMIs of 21.3, 26.0, 29.0, 32.5, 39.9 kg/m2), and CCI.
† Categorized according to the 10 Federal Regions drawn up by the Federal Emergency Management Agency: 1 (CT, MA, ME, NH, RI, and VT), 2 (NJ, NY, and PR), 3 (DC, DE, MD, PA, VA, and WV), 4 (AL, FL, GA, KY, MS, NC, SC, and TN), 5 (IL, IN, MI, MN, OH, and WI), 6 (AR, LA, NM, OK, and TX), 7 (IA, KS, MO, and NE), 8 (CO, MT, ND, SD, UT, and WY), 9 (AZ, CA, GU, HI, and NV), and 10 (AK, ID, OR, and WA).
AI/AN, American Indian/Alaska Native; AOR, adjusted odds ratio; BMI, body mass index; CCI, Charlson comorbidity index; PI/NH, Pacific Islander/Native Hawaiian; SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2; VA, Veterans Affairs.