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COVID-19 in Veterans: A Narrative Review
Yu-Chuan Chuang1, Hung-Wen Tsai2, Shih-An Liu3
1Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Insights
Veterans with COVID-19 faced severe symptoms and complications. This review highlights the need for increased attention to this population during pandemics, despite declining mortality rates.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- The COVID-19 pandemic disproportionately affected veterans, a vulnerable population.
- Veterans experienced severe COVID-19 symptoms and a higher risk of multi-organ complications.
- Existing literature on COVID-19 in veterans was reviewed to understand the pandemic's impact.
Purpose of the Study:
- To review the epidemiology, risk factors, diagnosis, clinical presentation, treatment, and outcomes of COVID-19 in veterans.
- To synthesize current knowledge on COVID-19 in the veteran population.
- To identify areas requiring further attention for veteran health during pandemics.
Main Methods:
- A literature review of 40 relevant papers published between January 1, 2020, and August 1, 2021.
- Analysis of data on veteran COVID-19 cases, including symptoms, complications, and mortality.
- Evaluation of risk stratification tools like the VA COVID-19 (VACO) Index.
Main Results:
- Common COVID-19 symptoms in veterans (fever, cough, dyspnea) mirrored the general population.
- Veterans faced increased risks of in-hospital complications, potentially due to age and comorbidities.
- While overall mortality declined, chronic COVID-19 posed risks for long-term functional dependence.
Conclusions:
- Veterans represent a special population requiring focused attention during health crises like the COVID-19 pandemic.
- Effective triage and risk stratification tools are crucial for managing COVID-19 in veterans.
- Further research is needed to address the long-term health consequences and optimize care for veterans affected by COVID-19.
Abstract:
Veterans are a special population that has been largely ignored during the corona virus disease 2019 (COVID-19) pandemic. Veterans with COVID-19 not only suffered symptoms from the disease but also had a higher risk of further development of in-hospital complications involving multiple organs. This article aims to review the current literature on the epidemiology, risk factors, diagnosis, clinical presentation, treatment, and outcome in veterans who contracted COVID-19 during the pandemic, using papers published between January 1, 2020 and August 1, 2021. Forty published papers were considered relevant to this review study. The COVID-19 pandemic not only caused a burden on health-care facilities but also affected the veterans population. Veterans with COVID-19 not only suffered symptoms from the disease but also had a higher risk of further development of in-hospital complications involving multiple organs. The dismal outcome might be attributed to old age and multiple comorbidities among veterans. Symptoms that may be seen in veterans with COVID-19 are comparable to those in the general population with fever, cough, and dyspnea, the most commonly reported. There are several approaches, such as self-assessment tools and virtual or telephone triage strategies, that can initially provide adequate evaluation of the symptoms related to COVID-19 in veterans. Adequate risk stratification could be carried out using the VA COVID-19 (VACO) Index, which predicts the risk of 30-day all-cause mortality after COVID-19 infection. There are several COVID-19 specific treatments that have been given to veterans; however, none of them have been proven to reduce the overall mortality in veterans. The overall mortality rate among veterans showed a declining trend. However, veterans suffering from chronic COVID-19 are at risk of dependence on activities of daily living after recovering from the illness. In summary, veterans are a special population that requires more attention especially during the COVID-19 pandemic.
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