Table 4. Trends over time in the associations (AORs*) of sociodemographic characteristics and comorbidity burden with risk of SARS-CoV-2–related mortality in a cohort of 9.1 million VA enrollees from February 2020 to February 2021.
| AORs* for SARS-CoV-2–related mortality (95% CI) | |||||||
|---|---|---|---|---|---|---|---|
| Entire period: February 2020 to February 2021 N = 9,127,673 |
February to April 2020 N = 9,127,673 |
May to June 2020 N = 9,059,880 |
July to August 2020 N = 8,998,307 |
September to October 2020 N = 8,922,764 |
November to December 2020 N = 8,857,881 |
January to February 2021 N = 8,790,422 |
|
| Sex | |||||||
| Female | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| Male | 1.59 (1.38 to 1.82) |
2.14 (1.28 to 3.59) |
1.21 (0.81 to 1.81) |
1.52 (1.05 to 2.21) |
1.96 (1.15 to 3.35) |
1.50 (1.17 to 1.94) |
1.68 (1.30 to 2.16) |
| Age (years) | |||||||
| 25 | 0.09 (0.04 to 0.17) |
0.02 (0.00 to 0.63) |
0.04 (0.00 to 0.82) |
0.01 (0.00 to 0.18) |
0.01 (0.00 to 0.45) |
0.03 (0.01 to 0.16) |
0.32 (0.14 to 0.73) |
| 35 | 0.31 (0.23 to 0.42) |
0.15 (0.03 to 0.73) |
0.22 (0.06 to 0.82) |
0.14 (0.04 to 0.43) |
0.10 (0.02 to 0.64) |
0.20 (0.10 to 0.41) |
0.56 (0.39 to 0.80) |
| 45 (reference) | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| 55 | 2.39 (2.14 to 2.67) |
3.47 (1.97 to 6.10) |
3.04 (1.88 to 4.92) |
3.12 (2.09 to 4.67) |
3.63 (1.86 to 7.08) |
2.69 (2.09 to 3.46) |
1.88 (1.61 to 2.19) |
| 65 | 5.05 (4.27 to 5.98) |
6.87 (3.55 to 13.30) |
6.72 (3.53 to 12.80) |
5.83 (3.57 to 9.52) |
7.18 (3.42 to 15.08) |
5.58 (3.98 to 7.82) |
4.06 (3.05 to 5.41) |
| 75 | 11.40 (9.77 to 13.30) |
11.68 (6.23 to 21.91) |
14.25 (7.81 to 25.99) |
12.30 (7.77 to 19.48) |
16.86 (8.29 to 34.28) |
14.26 (10.41 to 19.52) |
9.51 (7.36 to 12.30) |
| 85 | 20.37 (17.48 to 23.74) |
20.46 (10.92 to 38.34) |
30.53 (16.82 to 55.41) |
22.64 (14.30 to 35.85) |
33.38 (16.43 to 67.82) |
27.31 (19.97 to 37.34) |
16.74 (12.97 to 21.61) |
| Race | |||||||
| White | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| Black | 1.55 (1.47 to 1.64) |
3.85 (3.30 to 4.50) |
2.21 (1.89 to 2.60) |
1.84 (1.59 to 2.13) |
1.16 (0.95 to 1.43) |
1.08 (0.96 to 1.20) |
1.28 (1.16 to 1.42) |
| Asian | 0.82 (0.64 to 1.05) |
0.90 (0.29 to 2.83) |
1.39 (0.68 to 2.82) |
1.07 (0.59 to 1.96) |
1.40 (0.62 to 3.17) |
0.71 (0.44 to 1.16) |
0.60 (0.38 to 0.93) |
| AI/AN | 1.66 (1.39 to 1.98) |
1.93 (0.86 to 4.32) |
1.93 (1.00 to 3.73) |
1.67 (1.03 to 2.71) |
2.25 (1.37 to 3.71) |
1.57 (1.15 to 2.13) |
1.44 (1.04 to 2.01) |
| PI/NH | 1.03 (0.83 to 1.28) |
1.16 (0.48 to 2.80) |
0.97 (0.43 to 2.17) |
0.87 (0.46 to 1.62) |
0.76 (0.32 to 1.84) |
1.20 (0.85 to 1.71) |
0.96 (0.67 to 1.39) |
| Missing/unknown/refused | 0.85 (0.78 to 0.93) |
1.17 (0.82 to 1.66) |
0.77 (0.55 to 1.09) |
0.91 (0.71 to 1.17) |
0.73 (0.52 to 1.02) |
0.95 (0.81 to 1.11) |
0.71 (0.60 to 0.84) |
| Ethnicity | |||||||
| Non-Hispanic | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| Hispanic | 1.57 (1.45 to 1.70) |
0.74 (0.55 to 0.99) |
1.20 (0.91 to 1.59) |
2.65 (2.19 to 3.20) |
1.42 (1.04 to 1.95) |
1.57 (1.35 to 1.82) |
1.60 (1.39 to 1.84) |
| Missing/unknown/refused | 0.46 (0.40 to 0.52) |
0.26 (0.15 to 0.44) |
0.40 (0.26 to 0.63) |
0.44 (0.31 to 0.63) |
0.45 (0.29 to 0.71) |
0.35 (0.28 to 0.44) |
0.65 (0.52 to 0.80) |
| US Federal Region † | |||||||
| 1 | 0.90 (0.81 to 1.00) |
7.21 (5.37 to 9.69) |
2.61 (2.04 to 3.34) |
0.15 (0.08 to 0.26) |
0.12 (0.05 to 0.26) |
0.86 (0.69 to 1.07) |
0.62 (0.51 to 0.76) |
| 2 | 0.74 (0.68 to 0.81) |
7.93 (6.16 to 10.21) |
1.54 (1.21 to 1.94) |
0.08 (0.05 to 0.13) |
0.15 (0.09 to 0.25) |
0.51 (0.42 to 0.63) |
0.51 (0.43 to 0.60) |
| 3 | 0.89 (0.83 to 0.96) |
2.26 (1.68 to 3.05) |
1.24 (0.98 to 1.57) |
0.32 (0.24 to 0.42) |
0.59 (0.45 to 0.77) |
1.18 (1.02 to 1.37) |
0.86 (0.76 to 0.98) |
| 4 (reference) | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| 5 | 1.04 (0.98 to 1.11) |
2.92 (2.23 to 3.82) |
1.27 (1.03 to 1.57) |
0.33 (0.26 to 0.41) |
0.67 (0.54 to 0.84) |
2.00 (1.78 to 2.23) |
0.66 (0.58 to 0.75) |
| 6 | 1.31 (1.23 to 1.40) |
2.47 (1.84 to 3.31) |
0.89 (0.68 to 1.15) |
1.32 (1.14 to 1.53) |
1.09 (0.89 to 1.34) |
1.75 (1.54 to 1.98) |
1.04 (0.93 to 1.17) |
| 7 | 1.38 (1.27 to 1.51) |
1.23 (0.74 to 2.05) |
0.99 (0.69 to 1.41) |
0.51 (0.38 to 0.69) |
1.96 (1.58 to 2.44) |
2.48 (2.16 to 2.86) |
0.94 (0.80 to 1.11) |
| 8 | 1.16 (1.04 to 1.29) |
1.77 (0.98 to 3.18) |
1.60 (1.11 to 2.30) |
0.25 (0.15 to 0.41) |
1.62 (1.23 to 2.12) |
2.19 (1.85 to 2.59) |
0.57 (0.44 to 0.72) |
| 9 | 1.41 (1.32 to 1.51) |
1.16 (0.78 to 1.72) |
0.89 (0.68 to 1.18) |
1.05 (0.88 to 1.24) |
0.55 (0.41 to 0.74) |
1.79 (1.57 to 2.05) |
1.70 (1.52 to 1.89) |
| 10 | 0.76 (0.67 to 0.87) |
1.38 (0.73 to 2.60) |
0.81 (0.50 to 1.32) |
0.57 (0.40 to 0.82) |
0.69 (0.46 to 1.03) |
1.10 (0.88 to 1.37) |
0.57 (0.45 to 0.73) |
| Urban versus rural | |||||||
| Rural | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| Urban | 1.00 (0.96 to 1.04) |
2.48 (2.08 to 2.96) |
1.81 (1.57 to 2.10) |
1.11 (0.99 to 1.24) |
0.72 (0.62 to 0.83) |
0.80 (0.74 to 0.86) |
0.95 (0.88 to 1.02) |
| BMI (kg/m2) | |||||||
| 20 | 1.62 (1.53 to 1.71) |
1.53 (1.27 to 1.84) |
1.98 (1.68 to 2.33) |
1.68 (1.42 to 1.98) |
1.58 (1.29 to 1.95) |
1.77 (1.59 to 1.97) |
1.75 (1.58 to 1.94) |
| 25 (reference) | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| 30 | 1.00 (0.94 to 1.06) |
0.95 (0.78 to 1.17) |
0.92 (0.76 to 1.13) |
0.94 (0.79 to 1.13) |
0.94 (0.76 to 1.15) |
1.11 (0.99 to 1.23) |
0.95 (0.85 to 1.06) |
| 35 | 1.20 (1.13 to 1.27) |
1.00 (0.82 to 1.22) |
1.02 (0.84 to 1.24) |
1.28 (1.09 to 1.50) |
1.15 (0.95 to 1.39) |
1.32 (1.20 to 1.46) |
1.12 (1.02 to 1.24) |
| 40 | 1.48 (1.40 to 1.57) |
1.35 (1.11 to 1.64) |
1.30 (1.07 to 1.59) |
1.58 (1.34 to 1.86) |
1.48 (1.22 to 1.80) |
1.64 (1.48 to 1.81) |
1.33 (1.20 to 1.47) |
| CCI | |||||||
| 0 to 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| 2 to 3 | 3.06 (2.86 to 3.27) |
3.32 (2.60 to 4.26) |
2.29 (1.82 to 2.88) |
2.85 (2.35 to 3.47) |
3.02 (2.42 to 3.77) |
3.21 (2.85 to 3.61) |
3.28 (2.90 to 3.72) |
| 4 to 5 | 5.58 (5.22 to 5.97) |
5.30 (4.12 to 6.81) |
4.79 (3.85 to 5.97) |
5.30 (4.36 to 6.42) |
4.47 (3.55 to 5.63) |
5.80 (5.15 to 6.54) |
6.63 (5.87 to 7.50) |
| ≥6 | 9.46 (8.89 to 10.07) |
10.46 (8.34 to 13.12) |
8.64 (7.07 to 10.56) |
9.44 (7.91 to 11.27) |
8.90 (7.24 to 10.94) |
9.59 (8.58 to 10.72) |
11.41 (10.18 to 12.79) |
* 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, and 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.