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Racial disparities in the SOFA score among patients hospitalized with COVID-19.
Tolchin, Benjamin; Oladele, Carol; Galusha, Deron; Kashyap, Nitu; Showstark, Mary; Bonito, Jennifer; Salazar, Michelle C; Herbst, Jennifer L; Martino, Steve; Kim, Nancy; Nash, Katherine A; Nguemeni Tiako, Max Jordan; Roy, Shireen; Vergara Greeno, Rebeca; Jubanyik, Karen.
  • Tolchin B; Department of Neurology, Yale School of Medicine, New Haven, Connecticut, United States of America.
  • Oladele C; Equity Research and Innovation Center, Yale School of Medicine, New Haven, Connecticut, United States of America.
  • Galusha D; Equity Research and Innovation Center, Yale School of Medicine, New Haven, Connecticut, United States of America.
  • Kashyap N; Information Technology, Yale New Haven Health, New Haven, Connecticut, United States of America.
  • Showstark M; Yale School of Medicine Physician Assistant Online Program, New Haven, Connecticut, United States of America.
  • Bonito J; Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America.
  • Salazar MC; Department of Surgery, Yale School of Medicine, New Haven, Connecticut, United States of America.
  • Herbst JL; Quinnipiac University School of Law, North Haven, Connecticut, United States of America.
  • Martino S; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States of America.
  • Kim N; Department of Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America.
  • Nash KA; Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, United States of America.
  • Nguemeni Tiako MJ; Equity Research and Innovation Center, Yale School of Medicine, New Haven, Connecticut, United States of America.
  • Roy S; Washington University School of Medicine in St. Louis, St. Louis, Missouri, United States of America.
  • Vergara Greeno R; Equity Research and Innovation Center, Yale School of Medicine, New Haven, Connecticut, United States of America.
  • Jubanyik K; Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America.
PLoS One ; 16(9): e0257608, 2021.
Article in English | MEDLINE | ID: covidwho-1416907
Preprint
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ABSTRACT

BACKGROUND:

Sequential Organ Failure Assessment (SOFA) score predicts probability of in-hospital mortality. Many crisis standards of care suggest the use of SOFA scores to allocate medical resources during the COVID-19 pandemic. RESEARCH QUESTION Are SOFA scores elevated among Non-Hispanic Black and Hispanic patients hospitalized with COVID-19, compared to Non-Hispanic White patients? STUDY DESIGN AND

METHODS:

Retrospective cohort study conducted in Yale New Haven Health System, including 5 hospitals with total of 2681 beds. Study population drawn from consecutive patients aged ≥18 admitted with COVID-19 from March 29th to August 1st, 2020. Patients excluded from the analysis if not their first admission with COVID-19, if they did not have SOFA score recorded within 24 hours of admission, if race and ethnicity data were not Non-Hispanic Black, Non-Hispanic White, or Hispanic, or if they had other missing data. The primary outcome was SOFA score, with peak score within 24 hours of admission dichotomized as <6 or ≥6.

RESULTS:

Of 2982 patients admitted with COVID-19, 2320 met inclusion criteria and were analyzed, of whom 1058 (45.6%) were Non-Hispanic White, 645 (27.8%) were Hispanic, and 617 (26.6%) were Non-Hispanic Black. Median age was 65.0 and 1226 (52.8%) were female. In univariate logistic screen and in full multivariate model, Non-Hispanic Black patients but not Hispanic patients had greater odds of an elevated SOFA score ≥6 when compared to Non-Hispanic White patients (OR 1.49, 95%CI 1.11-1.99).

INTERPRETATION:

Given current unequal patterns in social determinants of health, US crisis standards of care utilizing the SOFA score to allocate medical resources would be more likely to deny these resources to Non-Hispanic Black patients.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / Organ Dysfunction Scores / COVID-19 Type of study: Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: North America Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0257608

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / Organ Dysfunction Scores / COVID-19 Type of study: Observational study / Prognostic study / Risk factors Limits: Adolescent / Adult / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: North America Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0257608