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
Background: It Is Well Known That Minorities Have Lower Access To Healthcare And At The Same Time Are Widely Affected By Many Comorbidities. This Predisposes Them To Worse Outcomes Compared To Others In The Current Pandemic. We Aimed To Study The Gastrointestinal (Gi) Symptoms, Comorbidities, And Clinical That Associate Covid-19 Outcomes In These Populations. Methods: We Analyzed Prospective And Retrospective Data From Sars-Cov-2 Positive Hospitalized Patients (N=5,932) From 9 Hospitals Including New York (3 Hospitals), Indiana, Rhode Island, District Of Columbia, Georgia, Michigan, And Maryland Between March And September 2020. Demographics, Comorbidities, Clinical Symptoms, And Median Laboratory Values Were Collected. The Primary Outcome Was The Rate Of In-Hospital Death. Secondary Outcomes Included Frequency And Duration Of Invasive Mechanical Ventilation, Frequency Of Treatment, And Liver Function Following Admission. Statistical Analysis Of Symptoms, Comorbidities, And Lethality Was Performed By Using Spss. Results: There Were 3713 With (62.7%) African Americans (Aa), 294 (5%) Hispanics, 1,418 (23.9%) Whites, 94 (1.5%) Asian, And 187 (3.2%) Others, 64 (1.1%) Decline, 150 (2.5%) Unknown. From 5,631 Known Ethnicity, The Average Age For Alive And Dead Was, 58 And 68 For Aa, 58 And 77 For Whites, 44 And 61 For Hispanic, And 51 And 63 Years For Asians. Males Were 47%, 41%, 47%, And 43% Among Aas, Hispanics, Whites, And Asians, Respectively. Lethality Rates Were 14.3%, 6.4%, 15.6%, Among Aas, Hispanics, And Whites, Respectively. In Chi-Squared Analysis, An Association With Lethality Was Found For Elevated Bun 14 (21.10%), Creatinine 14 (21.10%), Ferritin, Crp 304 (16.20%), D-Dimers 267 (18.00%), Ast 264 (21.10%), Prc, Troponin, Low Hemoglobin, Coronary Artery Disease, Cancer, Cardiac Disease, Hypertension (18.8%), Copd, Diabetes 281(17.20%), Diarrhea14 (21.10%), Fatigue 14 (21.10%). Use Of Glucocorticoid, Intubation, Mechanical Ventilation, Respiratory Failure, Shortness Of Breath Correlated With Death In A Significant Manner. Male Gender 311 (18.00%) And White And African Races Have A Higher Rate Of Death. These Symptoms And Commodities Were Seen Across The Board In All Races, However, Diarrhea Was Among The Most Common Gi Symptom In African Americans 50 (21.90%). Conclusion: Our Study Is Among The Largest Minority Covid-19 With Gi Manifestation That Shows Diarrhea And Elevated Liver Enzyme Ast Is Associated With Death. High Lethality Rate In African Americans In Comparison With Hispanics Is Likely Related To High Frequencies Of Comorbidities Such As Cardiovascular (Hypertension), And Diabetes. Prospective Investigations Will Likely Help A Better Characterization Of Minority Covid-19 Patients And A Better Understanding Of Factors Underlying The Observed Disparities