COVID-19 Infection Among Airborne Hazards Open Burn Pit Registry Participants Utilizing the VA

Abstract

Background: Veterans are concerned about their risk of coronavirus disease 2019 (COVID-19) and whether their deployment experience and/or exposures increase their risk of infection as well as associated morbidity and mortality. This is particularly important for members of armed services and Veterans who have sustained both civilian- and deployment-related occupational and environmental exposures and may potentially be at higher risk. Here, we describe the number of cases and patient characteristics among deployed Veterans who have participated in the Airborne Hazards and Open Burn Pit Registry (AHOBPR) utilizing the Veterans Health Administration (VHA). Methods: To explore the number of potential COVID-19 cases within the AHOBPR, we cross-referenced VHA medical records from March - November 2020 with the prospectively maintained AHOBPR database. As of November 25, 2020, there were 221,124 AHOBPR participants who were deployed to the Southwest Asia theater of operations on or after August 2, 1990, or deployed to Afghanistan or Djibouti after September 11, 2001. Data sources for the descriptive data analysis included the AHOBPR self-administered questionnaire and VHA medical records. Results: 89,318 VHA enrollees tested positive for COVID-19 between March and November 2020. Among all of the positive cases who underwent COVID-19 testing with VHA, 1,872 (2.0%) were AHOBPR participants. There were 5,022 known deaths of which 7 were AHOBPR participants. The majority of AHOBPR cases were men (85.9%) with a median age of 44 (range: 24 - 74 years), consistent with the demographics of the AHOBPR cohort (85.5% men, 43 median age). Eighty-nine (4.75%) of those tested positive were hospitalized in the VA and 40 (2.1%) were in the ICU. The mean ICU stay was 5.8 days (SD 7.2). The most frequently identified comorbidities among AHOBPR cases were of bronchitis (n=112, 5.9%), COPD (n=100, 5.3%), and hypertension (n=604, 32.3%). Conclusion: Approximately 13.8% of AHOBPR participants who received testing within VHA tested positive for COVID-19. Demographic characteristics of these cases reflect those of the broader AHOBPR, and comorbidity burden appears similar to the larger VHA and civilian population. Ongoing efforts are underway to investigate the role for deployment exposures and risk of COVID-19 and its associated morbidity and mortality.