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Cosmos Study

Adults No More Susceptible to Common Infections and Illnesses in 2023 Than Prior to the COVID-19 Pandemic

July 16, 2024
Dual-Team Study
Team A:Gretchen Vitek, RNJoe Deckert, PhD
Team B:Kersten Bartelt, RNTed Stamp

Key Findings

  • Among patients aged 18 to 50, the prevalence of asthma, COPD, pneumonia, shingles, influenza, sepsis, gastritis, and pancreatitis did not increase in 2023 compared to 2019. 
  • Strep throat rates, however, did increase from 0.63% of patients in 2019 to 0.85% of patients in 2023. 
  • Asthma rates decreased the most, from 7.84% of patients in 2019 to 7.00% of patients in 2023. 

The prevalence of disease over time provides valuable insights into changes in population health and the effectiveness of public health interventions. Recently, there have been reports of increased susceptibility to disease following the pandemic.1  

To understand whether the rate of disease is higher after the pandemic compared to before, we studied the prevalence of various diseases in 2019 and in 2023 among adult patients aged 18 to 50. The diseases were grouped into three categories for analysis: respiratory diseases (asthma, pneumonia, and COPD), infectious diseases (strep throat, shingles, sepsis, and influenza), and gastrointestinal (GI) tract diseases (gastritis and pancreatitis). Patients were matched 1:1 between 2019 and 2023 based on patient age, sex, race, ethnicity, Social Vulnerability Index quartile, and Rural Urban Commuting Area (RUCA) score. 

We found that rates of respiratory diseases have decreased. Asthma rates decreased from 7.84% in 2019 to 7.00% in 2023, COPD decreased from 0.44% to 0.32%, and pneumonia decreased from 0.31% to 0.21%, as seen in Figure 1. Among infectious diseases, we saw an increase in the rate of strep throat, going from 0.63% in 2019 to 0.85% in 2023, which aligns with our previous findings.2 The rates of shingles, sepsis, and influenza were mostly unchanged with small decreases in prevalence in 2023 compared to 2019. We found that gastritis rates were higher in 2019 than 2023, going from 0.82% of patients to 0.60% of patients. Meanwhile, pancreatitis remained unchanged. 

Figure 1
Diseases Rates in 2019 and 2023
Diseases Rates in 2019 and 2023
Figure 1. The rate of respiratory, infectious, and GI tract diseases in 2019 and 2023. 

Rates for chlamydia, E Coli, acute hepatitis, carditis, nephritis, Lyme disease, RSV, norovirus, tuberculosis, salmonella, and meningitis were too low to adequately compare. 

These data come from Cosmos, a dataset created in collaboration with a community of Epic health systems representing more than 256 million patient records from 1,500 hospitals and more than 34,100 clinics from all 50 states and Lebanon. This study was completed by two teams that worked independently, each composed of a clinician and research scientists. The two teams came to similar conclusions. Graphics by Brian Olson. 

References

  1. Hong J, Shrivastava B. Yes, Everyone Really Is Sick a Lot More Often After Covid. Bloomberg. Published June 14, 2024. https://www.bloomberg.com/news/features/2024-06-14/why-is-everyone-getting-sick-behind-the-global-rise-in-rsv-flu-measles?utm_campaign=news&utm_medium=bd&utm_source=applenews&leadSource=uverify%20wall. Accessed June 21, 2024. 
  2. Bartelt K, Piff A, Alban C, Joyce B. Strep Throat Infections Up 30% From 2017 Peak After Pandemic Drop. Epic Research. https://epicresearch.org/articles/strep-throat-infections-up-30-from-2017-peak-after-pandemic-drop. Accessed on June 19, 2024.