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

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.