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Introduction <p>This study evaluated the impact of “risk stacking” on COVID-19–related hospitalizations, emergency department/urgent care (ED/UC) visits, and outpatient visits among non-immunocompromised individuals aged 18–49 and 50–64&#xa0;years compared with immunocompromised individuals and those ≥ 65&#xa0;years.</p> Methods <p>Using Optum Clinformatics<sup>®</sup> data, adults were assigned to ≥ 1 category based on underlying CDC-categorized high-risk (HR) conditions: HR-Conclusive (from which immunocompromising conditions were separated), HR-Suggestive, Mixed Evidence, No HR Conditions. The impact of multimorbidity quantities and HR categories on COVID-19 healthcare resource utilization (HCRU) was evaluated.</p> Results <p>Overall (<i>n</i> = 10,631,427), the most prevalent conditions were hypertension (HTN; 47.4%), obesity/overweight (31.9%), chronic heart disease (CHD; 28.1%), and diabetes (DBT; 20.3%). COVID-19 HCRU was higher for CHD with DBT, CHD with obesity, and HTN with obesity than for immunocompromised individuals and highest among those aged ≥ 65&#xa0;years. Multimorbidity across multiple HR categories resulted in greater adjusted risk for COVID-19 HCRU for all ages.</p> Conclusion <p>Younger adults with multiple non-immunocompromising comorbidities had greater risk of COVID-19–related HCRU than those with immunocompromising conditions or ≥ 65&#xa0;years without multimorbidity. Stacking HR comorbidities increased the risk of HCRU. Ensuring broad vaccination and treatment recommendations and access is critical to mitigating severe COVID-19 in HR groups of any age.</p>

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Impact of Risk Stacking on COVID-19–Related Healthcare Utilization: A Real-World Retrospective Cohort Study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月5日

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  • Frank R. Ernst,
  • Leah McGrath,
  • Maya Reimbaeva,
  • Laura E. Choi,
  • Irini Zografaki,
  • Lili Jiang,
  • Santiago M. C. Lopez,
  • Mary M. Moran,
  • Laura Puzniak,
  • Luis Jodar,
  • Daniel Curcio,
  • Alejandro Cané

摘要

Introduction

This study evaluated the impact of “risk stacking” on COVID-19–related hospitalizations, emergency department/urgent care (ED/UC) visits, and outpatient visits among non-immunocompromised individuals aged 18–49 and 50–64 years compared with immunocompromised individuals and those ≥ 65 years.

Methods

Using Optum Clinformatics® data, adults were assigned to ≥ 1 category based on underlying CDC-categorized high-risk (HR) conditions: HR-Conclusive (from which immunocompromising conditions were separated), HR-Suggestive, Mixed Evidence, No HR Conditions. The impact of multimorbidity quantities and HR categories on COVID-19 healthcare resource utilization (HCRU) was evaluated.

Results

Overall (n = 10,631,427), the most prevalent conditions were hypertension (HTN; 47.4%), obesity/overweight (31.9%), chronic heart disease (CHD; 28.1%), and diabetes (DBT; 20.3%). COVID-19 HCRU was higher for CHD with DBT, CHD with obesity, and HTN with obesity than for immunocompromised individuals and highest among those aged ≥ 65 years. Multimorbidity across multiple HR categories resulted in greater adjusted risk for COVID-19 HCRU for all ages.

Conclusion

Younger adults with multiple non-immunocompromising comorbidities had greater risk of COVID-19–related HCRU than those with immunocompromising conditions or ≥ 65 years without multimorbidity. Stacking HR comorbidities increased the risk of HCRU. Ensuring broad vaccination and treatment recommendations and access is critical to mitigating severe COVID-19 in HR groups of any age.