ABSTRACT
Study Objectives: COVID-19 first emerged as an unknown respiratory virus in late 2019. Since the onset of the pandemic, the question of racial differences has been at the forefront of prognostic thought in determination of high-risk groups. Limited data is currently available about racial differences in symptoms of COVID-19. This research performed a retrospective data collection of patients in a hospital system in North Louisiana to determine if there was a statistical difference in presenting symptoms based on race. Methods: A total of 410 unique Medical Record Numbers (MRNs) were identified retrospectively. Data was collected from a mix of rapid and regular PCR nasal swabs collected from 4/1/2020 to 4/30/2020. Data collected included symptoms, race, ethnicity, occupation, sex and age. Symptoms were collected from their chief complaint, HPI, review of systems as well as nursing evaluation. Similar symptoms expressed in different wording were collapsed into larger categories. The rpart algorithm was used to perform association rule mining in both uncollapsed and collapsed data. Results: Black patients were the most represented race (74%) in our study. 399 patients were admitted with COVID-19 in April 2020. In Black patients, 306 were admitted (76.692%) compared to 79 White patients (19.799%). There were also significant differences on the basis of race between both the number of “typical” symptoms (Black=2.925 +- 2.067, White=2.367 +- 2.014, p=0.0330) and the more general “collapsed” categories of atypical symptoms (Black=1.036 +- 0.765, White=0.823 +- 0.844, p=0.026), but not concerning the number of atypical symptoms more specifically associated with COVID-19 (Black=0.428 +- 0.770, White=0.468 +- 0.749, p=0.589). This is concordant with our association rule mining results, which indicated that in Black patients, fever was frequently associated with myalgias, cough, and shortness of breath (lift=1.897) Conclusion: While evaluating the racial distribution of COVID-19 as it pertained to symptoms, Black patients were statistically more affected by COVID-19 in North Louisiana. Blacks make up 38% of the region's population but were 74% of the region’s COVID-19 cases. This was not observed in South Louisiana. Additionally, Black patients were more likely to be admitted than their White counterparts and were likely to have both more typical and atypical symptoms at presentation. Further investigation into the corresponding factors such as issues like weight, comorbid conditions, and genetic polymorphisms for ACE-I tropism should be explored to illuminate the proposed racial selection that SARS2-COVID-19 demonstrates for those of African descent.