ABSTRACT
Background: In the general population, African Americans have increased mortality risk with COVID-19. However, this has not been well-studied in CKD population. Methods: We analyzed a national Veteran cohort using data from the VA COVID-19 Shared Data Resource for COVID-positive patients (N=196,269) from 3/1/2020 -3/9/2021. Diagnosis of COVID-19 was defined as a confirmed positive laboratory test result. Index date was defined as the date of first positive COVID-19 test or the first negative test for patients who never tested positive for COVID-19. Baseline eGFR was defined as at least one outpatient serum creatinine measurement obtained within two years before the index date or the average of the two closest serum creatinine measurements obtained within two years before the index date. We identified 58,743 patients with valid eGFR measurements. Of this cohort, 51,002 were African American or Caucasian. Mortality data were available for 50,830 patients. We used Cox regression models to compare COVID-19 mortality in African Americans versus Caucasians based on pre-COVID eGFR stratification. Results: Of the COVID-positive patients with available eGFR and mortality data, baseline mean age was 60 ± 17 years, 24% African American, 76% Caucasian, and 21% with eGFR <60. There were 627 deaths among African Americans and 2,480 deaths among Caucasians. Average follow-up duration was 0.5 ± 0.3 years in African Americans and 0.4 ± 0.2 years in Caucasians. While there was no difference in mortality risk between African American and Caucasian Veterans without CKD, African Americans had lower mortality risk when compared to Caucasians in the CKD subgroup (Table 1). Conclusions: In the CKD subgroup, African Americans have lower COVID-19 mortality than Caucasians. The reasons for this observation are unclear.