{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T07:07:12Z","timestamp":1766387232842,"version":"3.48.0"},"reference-count":32,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000125","name":"National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U50OH009739"],"award-info":[{"award-number":["U50OH009739"]}],"id":[{"id":"10.13039\/100000125","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The impact of physical health conditions on coronavirus disease of 2019 (COVID-19) severity in World Trade Center disaster-exposed populations remains understudied. We examined the association of type, number and diagnosis time of pre-existing health conditions with COVID-19 severity, using the WTC Health Registry (WTCHR). We analyzed 3568 WTCHR enrollees with self-reported severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a 2021 follow-up survey. COVID-19 severity was measured by self-reported symptom duration (&lt;2, 2\u20134, and &gt;4 weeks) and hospitalization (hospitalized versus not). Pre-existing gastroesophageal reflux disease (GERD), respiratory conditions, cardiovascular conditions, and diabetes were self-reported and categorized into four groups (no diagnosis, post-9\/11, pre-9\/11, and undefinable). We used multinomial logistic regression and binary logistic regression to analyze the association of comorbidities with COVID-19 symptom duration and hospitalization, respectively, adjusting for post-traumatic stress disorder and demographic factors. Analysis was also conducted separately by enrollee type: rescue and recovery workers (RRW) vs. community members (non-RRW). Having all four health conditions post-9\/11 was associated with longer symptom duration after SARS-CoV-2 infection (&gt;4 weeks) among RRW (AOR: 2.66, 95% CI: 1.03\u20136.87). Reporting a post-9\/11 respiratory condition was associated with an increased risk of being hospitalized among RRW and an increased risk of longer symptom duration (&gt;4 weeks) among non-RRW. While post-9\/11 diabetes was associated with an increased risk of longer symptom duration among RRW, post-9\/11 GERD and pre-9\/11 cardiovascular conditions were associated with an increased risk of longer symptom duration and being hospitalized among non-RRW, respectively. The impact of certain health conditions on COVID-19 severity varied across enrollee types and time of diagnosis. Given the lasting health impacts of 9\/11-related exposures, targeted medical surveillance and proactive healthcare interventions are critical for mitigating the risk of severe COVID-19 illness in this population.<\/jats:p>","DOI":"10.3390\/ijerph23010010","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T07:01:33Z","timestamp":1766386893000},"page":"10","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of COVID-19 Severity with Comorbidities: Results from the World Trade Center Health Registry"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0144-1292","authenticated-orcid":false,"given":"Janette","family":"Yung","sequence":"first","affiliation":[{"name":"World Trade Center Health Registry, Center for Population Health Data Science, New York City Department of Health and Mental Hygiene, Long Island City, NY 11101, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6089-6799","authenticated-orcid":false,"given":"Rebecca D.","family":"Kehm","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7812-8878","authenticated-orcid":false,"given":"Jiehui","family":"Li","sequence":"additional","affiliation":[{"name":"World Trade Center Health Registry, Center for Population Health Data Science, New York City Department of Health and Mental Hygiene, Long Island City, NY 11101, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2145-1348","authenticated-orcid":false,"given":"James E.","family":"Cone","sequence":"additional","affiliation":[{"name":"World Trade Center Health Registry, Center for Population Health Data Science, New York City Department of Health and Mental Hygiene, Long Island City, NY 11101, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1289\/ehp.6702","article-title":"Health and environmental consequences of the world trade center disaster","volume":"112","author":"Landrigan","year":"2004","journal-title":"Environ. 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