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Racial Differences and In-Hospital Outcomes Among Hospitalized Patients with COVID-19.
Elbadawi, Ayman; Elgendy, Islam Y; Joseph, Douglas; Eze-Nliam, Chete; Rampersad, Penelope; Ouma, Geoffrey; Bhandari, Rohan; Kirksey, Lee; Chaudhury, Pulkit; Chung, Mina K; Kalra, Ankur; Mehta, Neil; Bartholomew, John R; Sahai, Aditya; Svensson, Lars G; Cameron, Scott J.
  • Elbadawi A; Division of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX, USA.
  • Elgendy IY; Department of Cardiology, Baylor College of Medicine, Houston, TX, USA.
  • Joseph D; Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar.
  • Eze-Nliam C; Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Rampersad P; Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Ouma G; Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Bhandari R; Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Kirksey L; Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Chaudhury P; Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, OH, USA.
  • Chung MK; Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Kalra A; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
  • Mehta N; Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Bartholomew JR; Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
  • Sahai A; Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic, Cleveland, OH, USA.
  • Svensson LG; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
  • Cameron SJ; Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
J Racial Ethn Health Disparities ; 9(5): 2011-2018, 2022 10.
Article in English | MEDLINE | ID: covidwho-1401116
ABSTRACT

OBJECTIVE:

There is a paucity of data on how race affects the clinical presentation and short-term outcome among hospitalized patients with SARS-CoV-2, the 2019 coronavirus (COVID-19).

METHODS:

Hospitalized patients ≥ 18 years, testing positive for COVID-19 from March 13, 2020 to May 13, 2020 in a United States (U.S.) integrated healthcare system with multiple facilities in two states were evaluated. We documented racial differences in clinical presentation, disposition, and in-hospital outcomes for hospitalized patients with COIVD-19. Multivariable regression analysis was utilized to evaluate independent predictors of outcomes by race.

RESULTS:

During the study period, 3678 patients tested positive for COVID-19, among which 866 were hospitalized (55.4% self-identified as Caucasian, 29.5% as Black, 3.3% as Hispanics, and 4.7% as other racial groups). Hospitalization rates were highest for Black patients (36.6%), followed by other (28.3%), Caucasian patients (24.4%), then Hispanic patients (10.7%) (p < 0.001). Caucasian patients were older, and with more comorbidities. Absolute lymphocyte count was lowest among Caucasian patients. Multivariable regression analysis revealed that compared to Caucasians, there was no significant difference in in-hospital mortality among Black patients (adjusted odds ratio [OR] 0.53; 95% confidence interval [CI] 0.26-1.09; p = 0.08) or other races (adjusted OR 1.62; 95% CI 0.80-3.27; p = 0.18). Black and Hispanic patients were admitted less frequently to the intensive care unit (ICU), and Black patients were less likely to require pressor support or hemodialysis (HD) compared with Caucasians.

CONCLUSIONS:

This observational analysis of a large integrated healthcare system early in the pandemic revealed that patients with COVID-19 did exhibit some racial variations in clinical presentation, laboratory data, and requirements for advanced monitoring and cardiopulmonary support, but these nuances did not dramatically alter in-hospital outcomes.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: J Racial Ethn Health Disparities Year: 2022 Document Type: Article Affiliation country: S40615-021-01140-2

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: J Racial Ethn Health Disparities Year: 2022 Document Type: Article Affiliation country: S40615-021-01140-2