ABSTRACT
SESSION TITLE: Studies on COVID-19 Infections Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: Some co-morbidities and racial/ethnic groups are associated with worse COVID-19 outcomes. Is there a statistically significant difference in baseline characteristics and co-morbidities among racial and ethnic groups? This question was explored in a descriptive study among patients admitted to Hartford HealthCare. METHODS: A retrospective review of 7049 patients admitted with COVID-19 within the Hartford HealthCare (HHC) System from Feb 23, 2020 to July 15, 2021 was performed via the COVID-19 Research Registry at HHC (an IRB approved registry of patients who tested positive for COVID-19 within HHC). Racial and ethnic categories were compared using chi-square test and multiple column proportions were compared using Bonferroni method. RESULTS: The cohort was comprised of 52% males with an average age of 65 years (SD=17). 20% were non-survivors. Race was reported as 61% White, 22% Other, 13% African American (AA), 2% Asian, 2% Grouped Races (including American Indian, Pacific Islander, refused or unknown). 23% of the cohort reported their ethnicity as Hispanic. The “Other” racial group is comprised of 87% Hispanic ethnicity. A significantly higher proportion of White was >80 years old (30%) as compared to AA (13%), Asian (11%) and Other (13%) categories. No difference in gender distribution was noted. White had increased proportions of CAD (23%) as compared to Grouped and Other groups (10-20%) and COPD (15%) and atrial fibrillation (19%) as compared to all groups (4-10%). A higher proportion of AA had obesity (15%) as compared to Asian and White groups (4-13%) and hypertension (59%) and heart failure (21%) as compared to Asian, Grouped and Other groups (39-52%, 6-14% respectively). AA also had a higher proportion of CKD (42%) as compared to all groups (18-35%). Those in the Other category (87% Hispanic) had increased proportion of diabetes mellitus (41%) as compared to all groups (23-29%) except AA and asthma (16%) compared to all groups (6-12%). A significantly higher proportion of Asian was on private insurance (42%) as compared to all groups (19-23%) except Grouped Races and had lower proportions or no statistically significant difference in co-morbidities. Highest proportion of Other was on Medicare/Medicaid (80%), followed by White (77%), AA (76%), Grouped Races (66%) then Asian (57%). CONCLUSIONS: This descriptive study found statistically significant differences in age, co-morbidites and insurance status among racial/ethnic groups admitted with COVID-19 at HHC. CLINICAL IMPLICATIONS: Studies have shown disproportionate impact of COVID-19 on minorities. Review of our hospitalized cohort shows that perhaps it is not race itself, but rather a complex interaction between patient factors and social determinants of health that likely plays a an essential role. A more complete study looking at the social determinants of health and its impact on COVID-19 mortality would be helpful to direct community interventions. DISCLOSURES: No relevant relationships by Jyoti Chhabra No relevant relationships by Jeffrey Mather No relevant relationships by Hnin Hnin Oo No relevant relationships by Oscar Serrano No relevant relationships by Joseph Tortora
ABSTRACT
Background: Impact of COVID19 on cancer care delivery and outcomes remains unknown. Few trials have investigated patients' perceived risks and benefits, and cancer care delivery (CCD) alterations related to COVID19. We sought to identify differences on behaviors and social determinants of health in Hispanics and other underrepresented populations (H/UP) compared to the general population (GP). Methods: An IRB-approved validated 27-item questionnaire was offered in English and Spanish to all pts. receiving cancer care at participating cancer centers over a 4 month period. Examined variables included demographic information, social risk and behavioral factors, preferred sources of health information, and overall satisfaction with CCD during the pandemic. Results: A total of 180 pts were enrolled in the study. Compared to GP, H/UP's perceived risk of COVID19 was higher with 93% vs 87% more likely to cancel or avoid social gatherings and 54% vs 46% more likely to change daily routine. H/UP appeared more concerned with personal and financial safety;if unable to find work/get paid for 2 weeks, 26% H/UP vs 10% GP would struggle to keep up with expenses. 40% H/UP vs 10% GP have concerns on perceived ability to secure food on short term and consider COVID19 a major threat to their health (70% vs 46%) and financial situation (63% vs 35%). H/UP's perceived benefits of protective measures is higher with 81% vs 60% routinely practicing social distancing (SD) and 79% vs 66% in agreement with punitive actions for not following SD. Analysis demonstrated no significant difference by age, gender, level of education, marital status, however Hispanic ethnicity and Spanish as primary language was a statistically significant variable (p = 0.025) in perceived risks and satisfaction with CCD. No major differences were noted on sources of health information although more H/UP relied on social media (33% vs 24%). H/UP appeared to be more skeptical about availability and safety of targeted vaccines (40% vs 15%). Satisfaction regarding CCD was comparable (84% vs 86%), although more H/UP perceived CCD alterations (15% vs 10%). Going forward, H/UP would prefer to incorporate virtual visits (VV) when possible (36% vs 25%). Conclusions: COVID19- related societal, financial, health and personal fears are increased in H/UP which likely negatively affects quality of life of these at-risk populations. H/UP's trust in SD recommendations is heightened although linguistically and culturally appropriate information may be deficient. H/UP's belief in vaccine availability and safety is comparable to GP, although recent reports suggest deeper fear and emphasize their fear of experimentation. Interventions aimed to decrease these differences could incorporate standard communications with special attention to social media. H/UP would prefer to incorporate VV into their care, although most do not possess appropriate technology to do so.