Adverse COVID-19 outcomes in American Veterans with age-related macular degeneration: a case–control study
Objectives Prior studies suggest that patients with age-related macular degeneration (AMD) have poorer COVID-19 outcomes. This study aims to evaluate whether AMD is associated with adverse COVID-19 outcomes in a large clinical database.Design Case–control study.Setting We obtained demographic and cl...
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| Language: | English |
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BMJ Publishing Group
2023-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/12/e071921.full |
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| author | Emily Y Chew Karen R Armbrust Anders Westanmo Amy Gravely Frederik J van Kuijk |
| author_facet | Emily Y Chew Karen R Armbrust Anders Westanmo Amy Gravely Frederik J van Kuijk |
| author_sort | Emily Y Chew |
| collection | DOAJ |
| description | Objectives Prior studies suggest that patients with age-related macular degeneration (AMD) have poorer COVID-19 outcomes. This study aims to evaluate whether AMD is associated with adverse COVID-19 outcomes in a large clinical database.Design Case–control study.Setting We obtained demographic and clinical data from a national US Veterans Affairs (VA) database for all Veterans aged 50 years or older with positive COVID-19 testing prior to 2 May 2021.Primary and secondary outcome measures The primary outcome measure was hospitalisation. Secondary outcome measures were intensive care unit admission, mechanical ventilation and death. Potential associations between AMD and outcome measures occurring within 60 days of COVID-19 diagnosis were evaluated using multiple logistic regression analyses.Results Of the 171 325 patients in the study cohort, 7913 (5%) had AMD and 2152 (1%) had severe AMD, defined as advanced atrophic or exudative AMD disease coding. Multiple logistic regression adjusting for age, Charlson Comorbidity Index, sex, race, ethnicity and COVID-19 timing showed that an AMD diagnosis did not significantly increase the odds of hospitalisation (p=0.11). Using a Bonferroni-adjusted significance level of 0.006, AMD and severe AMD also were not significant predictors for the secondary outcomes, except for AMD being modestly protective for death (p=0.002).Conclusions After adjusting for other variables, neither AMD nor severe AMD was a risk factor for adverse COVID-19 outcomes in the VA healthcare system. These findings indicate that an AMD diagnosis alone should not alter recommended ophthalmic management based on COVID-19 adverse outcome risk. |
| format | Article |
| id | doaj-art-875b2acf784d4ec2bec4ca1bf18e24f5 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
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| spelling | doaj-art-875b2acf784d4ec2bec4ca1bf18e24f52025-08-20T01:48:34ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-071921Adverse COVID-19 outcomes in American Veterans with age-related macular degeneration: a case–control studyEmily Y Chew0Karen R Armbrust1Anders Westanmo2Amy Gravely3Frederik J van Kuijk4Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland, USADepartment of Ophthalmology, Minneapolis VA Health Care System, Minneapolis, Minnesota, USADepartment of Pharmacy, Minneapolis VA Health Care System, Minneapolis, Minnesota, USAResearch Service, Minneapolis VA Health Care System, Minneapolis, Minnesota, USADepartment of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, USAObjectives Prior studies suggest that patients with age-related macular degeneration (AMD) have poorer COVID-19 outcomes. This study aims to evaluate whether AMD is associated with adverse COVID-19 outcomes in a large clinical database.Design Case–control study.Setting We obtained demographic and clinical data from a national US Veterans Affairs (VA) database for all Veterans aged 50 years or older with positive COVID-19 testing prior to 2 May 2021.Primary and secondary outcome measures The primary outcome measure was hospitalisation. Secondary outcome measures were intensive care unit admission, mechanical ventilation and death. Potential associations between AMD and outcome measures occurring within 60 days of COVID-19 diagnosis were evaluated using multiple logistic regression analyses.Results Of the 171 325 patients in the study cohort, 7913 (5%) had AMD and 2152 (1%) had severe AMD, defined as advanced atrophic or exudative AMD disease coding. Multiple logistic regression adjusting for age, Charlson Comorbidity Index, sex, race, ethnicity and COVID-19 timing showed that an AMD diagnosis did not significantly increase the odds of hospitalisation (p=0.11). Using a Bonferroni-adjusted significance level of 0.006, AMD and severe AMD also were not significant predictors for the secondary outcomes, except for AMD being modestly protective for death (p=0.002).Conclusions After adjusting for other variables, neither AMD nor severe AMD was a risk factor for adverse COVID-19 outcomes in the VA healthcare system. These findings indicate that an AMD diagnosis alone should not alter recommended ophthalmic management based on COVID-19 adverse outcome risk.https://bmjopen.bmj.com/content/13/12/e071921.full |
| spellingShingle | Emily Y Chew Karen R Armbrust Anders Westanmo Amy Gravely Frederik J van Kuijk Adverse COVID-19 outcomes in American Veterans with age-related macular degeneration: a case–control study BMJ Open |
| title | Adverse COVID-19 outcomes in American Veterans with age-related macular degeneration: a case–control study |
| title_full | Adverse COVID-19 outcomes in American Veterans with age-related macular degeneration: a case–control study |
| title_fullStr | Adverse COVID-19 outcomes in American Veterans with age-related macular degeneration: a case–control study |
| title_full_unstemmed | Adverse COVID-19 outcomes in American Veterans with age-related macular degeneration: a case–control study |
| title_short | Adverse COVID-19 outcomes in American Veterans with age-related macular degeneration: a case–control study |
| title_sort | adverse covid 19 outcomes in american veterans with age related macular degeneration a case control study |
| url | https://bmjopen.bmj.com/content/13/12/e071921.full |
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