ABSTRACT
Background: Coronavirus disease 2019 (COVID19) disproportionately struck minority populations.It is important to find out the determinants of such differences in outcomes. Methods:We collected data on 403 hospitalized COVID19 patients at Howard University Hospital.Statistical analysis of symptoms, comorbidities, and lethality was performed using SPSS.Results: There were 257 (63.7%) African Americans (AAs), 102 (25.3%) Hispanics, and 26(6.45%) Whites. The mean age was 55.6 years old (+/-18.5). However, the Hispanic's meanage was the lowest (43.66 years vs. 61.23 for Whites vs. 60 for AAs). 64 (15.8%) patientsdied. Age and race were risk factors for poor outcomes. Elevated Creatinine, Ferritin, CRPand D-dimers were associated with death (35.75% vs. 2.61%), (24.72% vs. 9.9%), (22.7%vs. 7.8%), and (21% vs. 0%), respectively. Hydroxychloroquine treatment did not associatewith a better prognosis (25.92% vs. 14.23%). Abdominal pain, anorexia, diarrhea, nausea,and vomiting did not have any effect on the outcome. Elevated liver enzymes associatedwith poor outcome. There was more mortality in patients with cardiac diseases (25.67%vs. 14.33). Immunocompromised patients had a higher mortality rate (40% vs. 15.31%).Cough and fever were the top symptoms in our patients, but they were unrelated to theoutcome. As for treatment, patients receiving glucocorticoid displayed higher mortality(39.1% vs. 11.8%). Also, patients with shortness of breath (21.6 vs. 7.3%), those undergoingIntubation (66.6% vs. 14.5%), and mechanical ventilation (70.1% vs. 5.1%) had a highmortality rate. Conclusion: Overall, elevated liver enzymes, ferritin, CRP, and D-dimers arerobust markers of poor prognosis. The African Americans in our study displayed the highestmortality as they consisted of an older population when compared to the Hispanic group.GI symptoms did not correlate with outcome, however, they are likely important to followas the virus persists within the GI system, even after clearing from the respiratory system.
ABSTRACT
Coronavirus (SARS-CoV-2) has caused a severe outbreak in the United States and theworld, and currently causing a global pandemic. SARS-CoV-2 mostly causes respiratory andgastrointestinal symptoms (GI). Clinical manifestations range from mild cold-like symptomsto more severe diseases such as bronchitis, pneumonia, severe acute respiratory distresssyndrome, multi-organ failure, and even death. Coronaviruses (SARS-CoV-1, MERS-CoV,and SARS-CoV-2) seem to less commonly affect children and cause fewer symptoms andless severe disease in this age group compared with adults. We aimed to study SARS-COV-2 and associated GI symptoms in pediatric patients (<18 years) in the USA. Methods: Weanalyzed data from SARS-CoV-2 positive patients evaluated at healthcare centers and hospitalsin the USA (N=6,639) including at least 208 centers/hospitals between January 20th, 2020,and November 5th, 2020. The US consists of a total pediatric population that exceeds 74.2million. Demographics, comorbidities, and clinical symptoms were collected. Statisticaldescriptive analysis and correlation analyses of symptoms were performed. Results: Of 6,639hospitalized COVID-19 pediatric patients, 2,566 (38.6%) were White, 1,974 (29.7%) wereAfrican Americans, 2,040 (30.7%) were Hispanics and 986 (14.8%) were others. The averageage was 15 years and 51% were male. The most common symptoms in our overall cohortwere fever (43%) and cough (32%). Vomiting (11.5%) followed by diarrhea (9.7%) werethe main GI symptoms (9.7%), particularly in African American children. Conclusion: Wereport that cough and fever are the primary symptoms in hospitalized pediatric COVID-19patients in the US. Vomiting, abdominal pain, and diarrhea were common among thesepatients, with vomiting as the most prevalent GI symptom. Most hospitalized patients (~60%)were from African American and Hispanic minority populations.