{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:39:24Z","timestamp":1792463964919,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["200\u20102016\u201091799"],"award-info":[{"award-number":["200\u20102016\u201091799"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["CDC\u2010RFA\u2010FT\u201023\u20100069"],"award-info":[{"award-number":["CDC\u2010RFA\u2010FT\u201023\u20100069"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["CDC\u2010RFA\u2010FT\u201023\u20100069"],"award-info":[{"award-number":["CDC\u2010RFA\u2010FT\u201023\u20100069"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>This study estimates the incidence of symptomatic COVID\u201019 cases, both documented and undocumented, among U.S. Veterans across demographic groups from the beginning of the pandemic to the end of the public health emergency on May 11, 2023. By analyzing a cohort of Veterans alive as of March 1, 2020, we extended a mortality\u2010based estimation approach to measure COVID\u201019 incidence. We relaxed the assumptions of a constant infection fatality rate (IFR) over time and across age groups and broadened the model from considering only excess respiratory deaths to including excess all\u2010cause deaths. Descriptive analyses were performed to understand differential ascertainment biases among demographic groups. Resulting estimates suggested a significantly higher number of COVID\u201019 cases among Veterans than those documented in the electronic health record. We also identified varying biases among different demographic groups. These estimates offer a clearer view of COVID\u201019's impact on Veterans, accounting for missed cases among those who sought care outside of the VA. Differences between documented and estimated cases were substantial. Policymakers should recognize that actual numbers are likely much higher than documented and that documented rates may not be directly comparable across populations or time periods.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jmv.71040","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T07:45:14Z","timestamp":1782719114000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How Many Veteran COVID\u201019 Cases Were There during the Pandemic?"],"prefix":"10.1002","volume":"98","author":[{"given":"Wathsala N.","family":"Widanagamaachchi","sequence":"first","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine, Spencer Fox Eccles School of Medicine University of Utah Salt Lake City Utah USA"},{"name":"IDEAS Center, Veterans Affairs Salt Lake City Healthcare System Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1897-8840","authenticated-orcid":false,"given":"Ariana R.","family":"Callahan","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine, Spencer Fox Eccles School of Medicine University of Utah Salt Lake City Utah USA"},{"name":"IDEAS Center, Veterans Affairs Salt Lake City Healthcare System Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina M.","family":"Willson","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine, Spencer Fox Eccles School of Medicine University of Utah Salt Lake City Utah USA"},{"name":"IDEAS Center, Veterans Affairs Salt Lake City Healthcare System Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bree","family":"Barbeau","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine, Spencer Fox Eccles School of Medicine University of Utah Salt Lake City Utah USA"},{"name":"IDEAS Center, Veterans Affairs Salt Lake City Healthcare System Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia E.","family":"Lewis","sequence":"additional","affiliation":[{"name":"IDEAS Center, Veterans Affairs Salt Lake City Healthcare System Salt Lake City Utah USA"},{"name":"Division of Infectious Diseases University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian D.","family":"Dalton","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine, Spencer Fox Eccles School of Medicine University of Utah Salt Lake City Utah USA"},{"name":"IDEAS Center, Veterans Affairs Salt Lake City Healthcare System Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa W.","family":"Stevens","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine, Spencer Fox Eccles School of Medicine University of Utah Salt Lake City Utah USA"},{"name":"IDEAS Center, Veterans Affairs Salt Lake City Healthcare System Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Samore","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine, Spencer Fox Eccles School of Medicine University of Utah Salt Lake City Utah USA"},{"name":"IDEAS Center, Veterans Affairs Salt Lake City Healthcare System Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4572-8794","authenticated-orcid":false,"given":"Nathorn","family":"Chaiyakunapruk","sequence":"additional","affiliation":[{"name":"IDEAS Center, Veterans Affairs Salt Lake City Healthcare System Salt Lake City Utah USA"},{"name":"Department of Pharmacotherapy, College of Pharmacy University of Utah Salt Lake City Utah USA"},{"name":"Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences Chulalongkorn University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto M.","family":"Jones","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine, Spencer Fox Eccles School of Medicine University of Utah Salt Lake City Utah USA"},{"name":"IDEAS Center, Veterans Affairs Salt Lake City Healthcare System Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Department of Veterans Affairs COVID\u201019 national summary. accessed Jun 10 2024 https:\/\/www.accesstocare.va.gov\/Healthcare\/COVID19NationalSummary."},{"key":"e_1_2_12_3_1","unstructured":"United States \u2010 COVID\u201019 Overview. Johns Hopkins University Coronavirus Resource Center. accessed Oct 6 2024 https:\/\/coronavirus.jhu.edu\/region\/united-states."},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/eci.13669"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwae011"},{"key":"e_1_2_12_6_1","unstructured":"Surveillance & Data Analytics. CDC. accessed 10\u201006 2024 https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/covid-19-data-and-surveillance.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fscience%2Fscience-and-research.html."},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pcbi.1008994"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2103272118"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.42725"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0246772"},{"key":"e_1_2_12_11_1","unstructured":"Veterans Health Administration. accessed Oct 18 2023 https:\/\/www.va.gov\/health\/."},{"key":"e_1_2_12_12_1","unstructured":"VA COVID\u201019 Shared Data Resource https:\/\/www.hsrd.research.va.gov\/for_researchers\/cyber_seminars\/archives\/3810-notes.pdfn.d."},{"key":"e_1_2_12_13_1","unstructured":"Centers for Disease Control and Prevention. COVID\u201019 Public Health Emergency. Centers for Disease Control and Prevention. accessed Oct 23 2025 https:\/\/www.hhs.gov\/coronavirus\/covid-19-public-health-emergency\/index.html."},{"key":"e_1_2_12_14_1","unstructured":"2024 ICD\u201010\u2010CM Codes. accessed Aug 7 2024 https:\/\/www.icd10data.com\/ICD10CM\/Codes."},{"key":"e_1_2_12_15_1","unstructured":"Weekly United States COVID\u201019 Cases and Deaths by State. Centers for Disease Control and Prevention accessed June 10 2024 https:\/\/data.cdc.gov\/Case-Surveillance\/Weekly-United-States-COVID-19-Cases-and-Deaths-by-\/pwn4-m3yp\/about_data."},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.2307\/2983331"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.5595"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02867-1"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-02987-8"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.33706"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0248946"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-statistics-040120-010730"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pcbi.1011200"}],"container-title":["Journal of Medical Virology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.71040","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jmv.71040","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.71040","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T01:54:05Z","timestamp":1792461245000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.71040"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,29]]},"references-count":22,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/jmv.71040"],"URL":"https:\/\/doi.org\/10.1002\/jmv.71040","archive":["Portico"],"relation":{},"ISSN":["0146-6615","1096-9071"],"issn-type":[{"value":"0146-6615","type":"print"},{"value":"1096-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,29]]},"assertion":[{"value":"2025-12-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71040"}}