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Disparities in COVID-19 hospitalizations and mortality among black and Hispanic patients: cross-sectional analysis from the greater Houston metropolitan area.
Pan, Alan P; Khan, Osman; Meeks, Jennifer R; Boom, Marc L; Masud, Faisal N; Andrieni, Julia D; Phillips, Robert A; Tiruneh, Yordanos M; Kash, Bita A; Vahidy, Farhaan S.
  • Pan AP; Center for Outcomes Research, Houston Methodist, Josie Roberts Administration Building, 7550 Greenbriar Drive, Suite 4.123, Houston, TX, 77030, USA.
  • Khan O; Center for Outcomes Research, Houston Methodist, Josie Roberts Administration Building, 7550 Greenbriar Drive, Suite 4.123, Houston, TX, 77030, USA.
  • Meeks JR; Center for Outcomes Research, Houston Methodist, Josie Roberts Administration Building, 7550 Greenbriar Drive, Suite 4.123, Houston, TX, 77030, USA.
  • Boom ML; Department of Clinical Medicine, Houston Methodist, Houston, TX, USA.
  • Masud FN; Weill Cornell Medical College, New York, NY, USA.
  • Andrieni JD; Weill Cornell Medical College, New York, NY, USA.
  • Phillips RA; Department of Anesthesiology and Critical Care, Houston Methodist, Houston, TX, USA.
  • Tiruneh YM; Department of Clinical Medicine, Houston Methodist, Houston, TX, USA.
  • Kash BA; Weill Cornell Medical College, New York, NY, USA.
  • Vahidy FS; Center for Outcomes Research, Houston Methodist, Josie Roberts Administration Building, 7550 Greenbriar Drive, Suite 4.123, Houston, TX, 77030, USA.
BMC Public Health ; 21(1): 1330, 2021 07 06.
Article in English | MEDLINE | ID: covidwho-1477354
Preprint
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ABSTRACT

BACKGROUND:

Disparate racial/ethnic burdens of the Coronavirus Disease 2019 (COVID-19) pandemic may be attributable to higher susceptibility to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) or to factors such as differences in hospitalization and care provision.

METHODS:

In our cross-sectional analysis of lab-confirmed COVID-19 cases from a tertiary, eight-hospital healthcare system across greater Houston, multivariable logistic regression models were fitted to evaluate hospitalization and mortality odds for non-Hispanic Blacks (NHBs) vs. non-Hispanic Whites (NHWs) and Hispanics vs. non-Hispanics.

RESULTS:

Between March 3rd and July 18th, 2020, 70,496 individuals were tested for SARS-CoV-2; 12,084 (17.1%) tested positive, of whom 3536 (29.3%) were hospitalized. Among positive cases, NHBs and Hispanics were significantly younger than NHWs and Hispanics, respectively (mean age NHBs vs. NHWs 46.0 vs. 51.7 years; p < 0.001 and Hispanic vs. non-Hispanic 44.0 vs. 48.7 years; p < 0.001). Despite younger age, NHBs (vs. NHWs) had a higher prevalence of diabetes (25.2% vs. 17.6%; p < 0.001), hypertension (47.7% vs. 43.1%; p < 0.001), and chronic kidney disease (5.0% vs. 3.3%; p = 0.001). Both minority groups resided in lower median income (median income [USD]; NHBs vs. NHWs 63,489 vs. 75,793; p < 0.001, Hispanic vs. non-Hispanic 59,104 vs. 68,318; p < 0.001) and higher population density areas (median population density [per square mile]; NHBs vs. NHWs 3257 vs. 2742; p < 0.001, Hispanic vs. non-Hispanic 3381 vs. 2884; p < 0.001). In fully adjusted models, NHBs (vs. NHWs) and Hispanics (vs. non-Hispanic) had higher likelihoods of hospitalization, aOR (95% CI) 1.42 (1.24-1.63) and 1.61 (1.46-1.78), respectively. No differences were observed in intensive care unit (ICU) utilization or treatment parameters. Models adjusted for demographics, vital signs, laboratory parameters, hospital complications, and ICU admission vital signs demonstrated non-significantly lower likelihoods of in-hospital mortality among NHBs and Hispanic patients, aOR (95% CI) 0.65 (0.40-1.03) and 0.89 (0.59-1.31), respectively.

CONCLUSIONS:

Our data did not demonstrate racial and ethnic differences in care provision and hospital outcomes. Higher susceptibility of racial and ethnic minorities to SARS-CoV-2 and subsequent hospitalization may be driven primarily by social determinants.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Black or African American / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: BMC Public Health Journal subject: Public Health Year: 2021 Document Type: Article Affiliation country: S12889-021-11431-2

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Black or African American / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: BMC Public Health Journal subject: Public Health Year: 2021 Document Type: Article Affiliation country: S12889-021-11431-2