University of Wisconsin–Madison Medical College of Wisconsin

Clinical Features of COVID-19 Infection in Patients Treated at a Large Veterans Affairs Medical Center

Thomas J. Ebert, MD, PhD; Shannon Dugan; Lauren Barta, MD; Brian Gordon, MD; Calvin Nguyen-Ho; Paul S. Pagel, MD, PhD

Published online ahead of print November 17, 2020.

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ABSTRACT.

Introduction: During recent months, reports describing the characteristics of COVID-19 patients in China, Italy, and the United States have been published. Military veterans represent another unique population affected by COVID-19. This report summarizes the demographics and baseline clinical comorbidities in veterans testing positive for COVID-19 in Milwaukee, Wisconsin.

Methods: Patient evaluations were conducted at the Zablocki VA Medical Center, Milwaukee, Wisconsin between March 11 and June 1, 2020. Patient demographics, baseline comorbidities, home medications, presenting symptoms, and outcomes were obtained via electronic medical record.

Results: Ninety-five patients (88 men, 7 women) tested positive for COVID-19 and were evaluated. Fourteen required mechanical ventilation; 50 and 31 patients were treated in the hospital without ventilation or were discharged to home isolation, respectively. Discharged patients were younger than patients hospitalized. Most patients with COVID-19 were African American (63.2%). Patients whose disease progressed to mechanical ventilation had, on admission, more dyspnea, higher heart and respiratory rates, and lower oxygen saturation than other patients. COVID-19 patients who required mechanical ventilation had a longer length of stay and higher mortality than other groups and were more likely to have a history of hypertension and hyperlipidemia than patients who were discharged to home quarantine (85.7% and 78.6% vs 48.4% and 45.2%, respectively; P < 0.05 for each).

Conclusion: COVID-19-positive veterans are predominantly African American men with hypertension and hyperlipidemia receiving beta blockers or ACEi/ARB. COVID-19-positive veterans who presented with dyspnea, tachypnea, tachycardia, and hypoxemia were more likely to require endotracheal intubation and mechanical ventilation, had longer hospital length-of-stay, and experienced greater mortality than comparison groups.


Author Affiliations: Zablocki VA Medical Center and Medical College of Wisconsin, Milwaukee, Wis (Ebert, Dugan, Barta, Gordon, Nguyen-Ho, Pagel).
Corresponding Author: Thomas J. Ebert, MD, PhD, Department of Anesthesiology, 112A, Zablocki VA Medical Center, 5000 W National Ave, Milwaukee, WI 53295; phone 414.384.2000, ext 42429; email Thomas.Ebert@va.gov.
Acknowledgement: Helpful thoughts and comments were provided by Nathan Gundacker, MD, Infection Disease Faculty at the Zablocki VA Medical Center.
Funding/Support: None declared.
Financial Disclosures: None declared.
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