TY - JOUR
T1 - Racial Differences and In-Hospital Outcomes Among Hospitalized Patients with COVID-19
AU - Elbadawi, Ayman
AU - Elgendy, Islam Y.
AU - Joseph, Douglas
AU - Eze-Nliam, Chete
AU - Rampersad, Penelope
AU - Ouma, Geoffrey
AU - Bhandari, Rohan
AU - Kirksey, Lee
AU - Chaudhury, Pulkit
AU - Chung, Mina K.
AU - Kalra, Ankur
AU - Mehta, Neil
AU - Bartholomew, John R.
AU - Sahai, Aditya
AU - Svensson, Lars G.
AU - Cameron, Scott J.
N1 - Publisher Copyright:
© 2021, W. Montague Cobb-NMA Health Institute.
PY - 2022/10
Y1 - 2022/10
N2 - Objective: There is a paucity of data on how race affects the clinical presentation and short-term outcome among hospitalized patients with SARS-CoV-2, the 2019 coronavirus (COVID-19). Methods: Hospitalized patients ≥ 18 years, testing positive for COVID-19 from March 13, 2020 to May 13, 2020 in a United States (U.S.) integrated healthcare system with multiple facilities in two states were evaluated. We documented racial differences in clinical presentation, disposition, and in-hospital outcomes for hospitalized patients with COIVD-19. Multivariable regression analysis was utilized to evaluate independent predictors of outcomes by race. Results: During the study period, 3678 patients tested positive for COVID-19, among which 866 were hospitalized (55.4% self-identified as Caucasian, 29.5% as Black, 3.3% as Hispanics, and 4.7% as other racial groups). Hospitalization rates were highest for Black patients (36.6%), followed by other (28.3%), Caucasian patients (24.4%), then Hispanic patients (10.7%) (p < 0.001). Caucasian patients were older, and with more comorbidities. Absolute lymphocyte count was lowest among Caucasian patients. Multivariable regression analysis revealed that compared to Caucasians, there was no significant difference in in-hospital mortality among Black patients (adjusted odds ratio [OR] 0.53; 95% confidence interval [CI] 0.26–1.09; p = 0.08) or other races (adjusted OR 1.62; 95% CI 0.80–3.27; p = 0.18). Black and Hispanic patients were admitted less frequently to the intensive care unit (ICU), and Black patients were less likely to require pressor support or hemodialysis (HD) compared with Caucasians. Conclusions: This observational analysis of a large integrated healthcare system early in the pandemic revealed that patients with COVID-19 did exhibit some racial variations in clinical presentation, laboratory data, and requirements for advanced monitoring and cardiopulmonary support, but these nuances did not dramatically alter in-hospital outcomes.
AB - Objective: There is a paucity of data on how race affects the clinical presentation and short-term outcome among hospitalized patients with SARS-CoV-2, the 2019 coronavirus (COVID-19). Methods: Hospitalized patients ≥ 18 years, testing positive for COVID-19 from March 13, 2020 to May 13, 2020 in a United States (U.S.) integrated healthcare system with multiple facilities in two states were evaluated. We documented racial differences in clinical presentation, disposition, and in-hospital outcomes for hospitalized patients with COIVD-19. Multivariable regression analysis was utilized to evaluate independent predictors of outcomes by race. Results: During the study period, 3678 patients tested positive for COVID-19, among which 866 were hospitalized (55.4% self-identified as Caucasian, 29.5% as Black, 3.3% as Hispanics, and 4.7% as other racial groups). Hospitalization rates were highest for Black patients (36.6%), followed by other (28.3%), Caucasian patients (24.4%), then Hispanic patients (10.7%) (p < 0.001). Caucasian patients were older, and with more comorbidities. Absolute lymphocyte count was lowest among Caucasian patients. Multivariable regression analysis revealed that compared to Caucasians, there was no significant difference in in-hospital mortality among Black patients (adjusted odds ratio [OR] 0.53; 95% confidence interval [CI] 0.26–1.09; p = 0.08) or other races (adjusted OR 1.62; 95% CI 0.80–3.27; p = 0.18). Black and Hispanic patients were admitted less frequently to the intensive care unit (ICU), and Black patients were less likely to require pressor support or hemodialysis (HD) compared with Caucasians. Conclusions: This observational analysis of a large integrated healthcare system early in the pandemic revealed that patients with COVID-19 did exhibit some racial variations in clinical presentation, laboratory data, and requirements for advanced monitoring and cardiopulmonary support, but these nuances did not dramatically alter in-hospital outcomes.
KW - COVID-19
KW - Outcomes
KW - Race
KW - SARS-CoV-2
UR - https://www.scopus.com/pages/publications/85114665634
UR - https://www.scopus.com/pages/publications/85114665634#tab=citedBy
U2 - 10.1007/s40615-021-01140-2
DO - 10.1007/s40615-021-01140-2
M3 - Article
C2 - 34506011
AN - SCOPUS:85114665634
SN - 2197-3792
VL - 9
SP - 2011
EP - 2018
JO - Journal of Racial and Ethnic Health Disparities
JF - Journal of Racial and Ethnic Health Disparities
IS - 5
ER -