 This study examined the prevalence of multi-morbidity in the United States prior to the COVID-19 pandemic. It found that multi-morbidity was common, affecting over half of the population aged 20 years and up. The prevalence of multi-morbidity was higher among younger people, and was associated with age, race-ethnicity, socioeconomic status, and lack of access to healthcare. Additionally, cardiometabolic diseases such as obesity, hypolipidemia, hypotension, and diabetes were highly prevalent and were associated with severe disease and death from COVID-19. These findings suggest that multi-morbidity is a major contributor to the severity of COVID-19 cases and should be taken into account when developing strategies to prevent and treat the virus. This article was authored by Bijan Mossadegi, Roberta Kaysheta, Dolores Ondasuhu, and others.