Logan Reid
The COVID-19 pandemic has had a significant impact on the United States, with the country reporting its first case in Massachusetts in February 2020. While relatively few Americans have been officially diagnosed with COVID-19, a larger proportion claim they know someone who has been infected. As of March 2020, over 70% of Americans hospitalized with COVID-19 had at least one underlying health condition, with diabetes, chronic lung disease, and cardiovascular disease being the most common. The number of hospitalizations due to COVID-19 has varied over time, with a recent surge in cases across the US in the summer of 2025, driven by the 'razor blade throat' variant.
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What You'll Learn
Common pre-existing conditions: diabetes, lung disease, and cardiovascular disease
While COVID-19 can affect anyone, preliminary data from the CDC indicates that people with pre-existing conditions such as diabetes, chronic lung disease, and cardiovascular disease are at a higher risk of hospitalization and admission to the ICU.
Diabetes
Diabetes patients are considered high risk due to their immunocompromised state. Mark Schutta, an endocrinologist at Penn Medicine, explains that even well-controlled diabetics have a compromised immune system to a degree. When blood sugars rise above 200, which typically occurs after a meal, the body's ability to fight infections is disrupted. Furthermore, the presence of an infection can raise blood sugars, leading to a circular problem where immunity is continuously disrupted.
Lung Disease
Patients with interstitial lung disease (ILD) are at an increased risk of poor outcomes from COVID-19. An international multicenter study compared patients with ILD hospitalized for COVID-19 with patients without ILD. The study found that overall mortality was 49% in patients with ILD and COVID-19. After matching for age, sex, and comorbidities, patients with ILD and COVID-19 had a significantly poorer survival rate than those without ILD. Obese patients with ILD were also found to have an elevated risk of death.
Cardiovascular Disease
Cardiac involvement is common in COVID-19 patients, and those with underlying cardiovascular disease (CVD) are at an increased risk of severe disease and cardiac complications. Arrhythmias, acute coronary syndrome, and heart failure-related events have been observed in hospitalized COVID-19 patients with CVD. Abnormal cardiovascular resonance imaging (CMR) findings have been reported in COVID-19 survivors, raising concerns about long-term cardiac consequences.
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CDC estimates of hospitalizations
The CDC estimates of hospitalizations for COVID-19 are based on continuously collected surveillance data from patients with laboratory-confirmed COVID-19. This data is sourced from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET), which captures information from hospitals serving about 10% of the US population. The CDC uses this data to estimate a range of COVID-19-associated hospitalizations each week, providing insights into the impact on healthcare systems and guiding prevention strategies.
The CDC's preliminary estimates for the 2024-2025 period include cumulative estimates of COVID-19 hospitalizations, which are updated weekly as new data is reported through COVID-NET. These updates include new admissions and patients admitted in previous weeks who may have been missed in earlier reports. While COVID-19 is no longer considered a national public health emergency, the virus continues to cause illness, hospitalization, and death among Americans.
The CDC also provides estimates of the underlying health conditions prevalent among hospitalized COVID-19 patients. As of March 28, 2020, among the patients with available health data, 71% of hospitalized patients and 78% of those admitted to intensive care units had pre-existing conditions or risk factors. Diabetes, chronic lung disease, and cardiovascular disease were the most frequently reported pre-existing conditions.
In addition to hospitalization estimates, the CDC also offers projections of COVID-19 deaths. On March 31, 2020, the CDC projected that 100,000 to 240,000 Americans would eventually die from coronavirus. This projection was reached within two months, and the upper end was surpassed in November 2020. The CDC's ensemble forecast aggregates predictions from multiple sources to make its own forecast, and it has included 37 modeling groups as of December 2020.
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Racial disparities in hospitalizations
The COVID-19 pandemic has highlighted and exacerbated existing racial disparities in the United States. Studies have shown that racial and ethnic minority groups, particularly Black, Hispanic, Latino, Native American, and Native Hawaiian or Pacific Islander patients, have been disproportionately affected by the pandemic in terms of hospitalizations and emergency visits.
The Centers for Disease Control and Prevention (CDC) conducted a study analyzing administrative discharge data for approximately 300,000 hospitalized COVID-19 patients from March to December 2020. The study found that racial and ethnic minority groups had a higher proportion of COVID-19 hospitalizations compared to white patients, with the disparities being most pronounced between May and July. Latinos and Hispanics had the highest rates of hospitalizations across all four census regions of the U.S.
The CDC identified two main driving factors behind the disproportionate hospitalizations among minority groups: a higher risk of exposure to the virus and a higher risk for severe disease. Differences in occupational and housing conditions, as well as socioeconomic status, likely contributed to the higher risk of exposure among these communities. Additionally, underlying health conditions, such as diabetes, chronic lung disease, and cardiovascular disease, were more prevalent among minority groups, increasing their risk for severe COVID-19 illness requiring hospitalization.
The pandemic has brought to light the longstanding systemic inequities that impact the health of racial and ethnic minorities. These communities often face limited access to quality healthcare, unstable housing, and challenging job conditions, which contribute to worse health outcomes. By understanding these social determinants of health, strategies can be tailored to prevent illnesses and allocate resources more effectively to address health inequities.
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Summer 2025 surge in cases
As of July 2025, the United States is facing another wave of COVID-19, with cases rising in more than half of the states. This surge is fuelled by highly contagious new variants, causing an increase in Americans experiencing COVID symptoms such as sore throats, fevers, nausea, vomiting, and diarrhoea. The rise in cases is also attributed to waning immunity from prior infections and vaccinations, with mutated variants like Nimbus and Stratus taking hold.
According to the US Centers for Disease Control and Prevention (CDC), COVID-19 infections are either growing or likely growing in 26 states, with the West and South witnessing some of the most significant increases in transmission. While the CDC reports that the overall level of respiratory diseases, including COVID-19, remains "very low", emergency room visits for COVID-19 are on the rise, accounting for 0.5% of emergency room visits in the country as of mid-July, up from 0.3% at the beginning of the summer.
WastewaterSCAN, which monitors diseases through municipal wastewater systems, reports that national COVID-19 levels are in the "medium" category as of July 12, with at least nine states reporting "moderate," "high," or "very high" levels. The CDC's modelling and forecasting tools indicate that the reproductive number (Rt) for COVID-19 is above 1, suggesting that infections are increasing.
Experts recommend taking precautions such as wearing masks, especially when travelling, and getting vaccinated. The CDC continues to recommend vaccinations for all adults and suggests that parents consult doctors about vaccinating their children. The 2024-2025 COVID-19 vaccines are still available and recommended for most adults, and updated formulations are expected to be released in the fall of 2025.
While it is challenging to predict the magnitude of the summer 2025 COVID-19 wave, the surge in cases is evident, and public health practitioners are preparing and responding to the increasing transmission and hospitalisations.
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Effectiveness of vaccines in preventing hospitalizations
As of March 28, 2020, US states and territories had reported 122,653 coronavirus cases. The CDC reported that 71% of patients hospitalized with COVID-19 had at least one underlying health condition, with the most common pre-existing conditions being diabetes, chronic lung disease, and cardiovascular disease.
Vaccines have proven to be highly effective in preventing COVID-19-related hospitalizations. A study published in Frontiers in Public Health compared the effectiveness of the Pfizer-BioNTech and Sinopharm vaccines in reducing hospital admissions in Jordan. The study found that two doses of either vaccine at least fourteen days after administration provided a significant reduction in coronavirus-associated hospitalizations. The Pfizer-BioNTech vaccine was found to be more effective, with a vaccine effectiveness (VE) of 67% compared to Sinopharm's VE of 92%.
Another study, using data from over 67,000 laboratory-confirmed COVID-19-associated hospitalizations in adults aged 18 and older, found that unvaccinated persons were hospitalized at rates approximately 17 times higher than vaccinated persons. The study also showed that the rates of hospitalization for vaccinated individuals aged 65 and older were more than 90% lower than for unvaccinated individuals in the same age group.
Despite the proven effectiveness of vaccines in preventing hospitalizations, vaccine hesitancy remains a challenge. A study exploring COVID-19 vaccine hesitancy among healthcare workers identified six primary reasons for hesitancy, including conspiracy theories and concerns about unknown effects. Addressing these concerns through re-education and transparent communication is crucial to improving vaccination rates and reducing the impact of the pandemic.
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Frequently asked questions
As of March 28, 2020, 7,162 coronavirus patients with underlying health data available were hospitalized.
20% of Americans say they know someone who has been hospitalized for coronavirus.
Diabetes, chronic lung disease, and cardiovascular disease are the most commonly reported pre-existing conditions among Americans hospitalized with coronavirus.
As of July 24, 2025, COVID-19 cases and hospitalizations are rising across the US. However, weekly hospitalization rates have remained low, suggesting that the new variant may not be leading to severe illness.
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