461 - Presentation and Demographics of Veterans Tested for COVID-19 Infection

Background: COVID-19, caused by the Severe Acute Respiratory Syndrome-Related Coronavirus 2 (SARS-CoV-2), has been a major cause of morbidity and mortality in the United States since its emergence in Wuhan, China. As of June 2020, there are over 20,000 confirmed cases and nearly 700 deaths due to COVID-19 in Wisconsin, with the majority of COVID-19 related deaths occurring within Milwaukee County. COVID-19 infections are disproportionately affecting minority communities across the United States. Presentation and outcomes vary, with the elderly and those with underlying diseases having poorer outcomes. 

Methods: This retrospective chart review of patients tested for COVID-19 infection from March 2020-May 2020 at the Zablocki VA Medical Center, Milwaukee, WI evaluated demographics, comorbidities, presenting symptoms, and duration of symptoms. The primary outcomes analyzed were whether there were significant differences in demographic data, comorbidities, and presentation between patients testing positive or not positive for COVID-19.

Results: A total of 173 patients tested for COVID-19 were included during the study period, 82 positive and 91 otherwise. Univariate analysis of patient demographics and presenting symptoms are summarized in Table 1. A multivariable logistic regression using stepwise selection (AUC=0.7188) determined patients that tested positive for COVID-19, when controlling for demographics and comorbidities, were more likely to be African-American than White (OR 3.455, CI 1.733-6.887), and more likely to have a diagnosis of diabetes (OR 2.698, CI 1.36-5.353). However, race and diabetes were not informative when symptoms were included in a subsequent model (AUC=0.8458); patients testing positive for COVID-19 were more likely to present with diarrhea (OR 6.926, CI 1.760-6.926) and a higher temperature (OR 2.651, CI 1.533-4.584), but less likely to present with vomiting (OR 0.007, CI < .001-0.161) when compared to patients testing otherwise for COVID-19.Table 1: Univariate Analysis of Variables Associated with Testing Positive for COVID-19 at Zablocki VA Medical Center 3/2020-5/2020


Conclusion: Patients testing positive in Milwaukee County are more likely to be African-American and/or diabetic; further highlighting racial disparities in COVID-19.  Symptomology at presentation is more related to positive COVID-19 test results than demographics and comorbidities.