Racial and Ethnic Disparities in Rates of COVID-19-Associated Hospitalization, Intensive Care Unit Admission, and In-Hospital Death in the United States From March 2020 to February 2021.
JAMA Netw Open
; 4(10): e2130479, 2021 10 01.
Article
in English
| MEDLINE | ID: covidwho-1482074
ABSTRACT
Importance Racial and ethnic minority groups are disproportionately affected by COVID-19. Objectives:
To evaluate whether rates of severe COVID-19, defined as hospitalization, intensive care unit (ICU) admission, or in-hospital death, are higher among racial and ethnic minority groups compared with non-Hispanic White persons. Design, Setting, andParticipants:
This cross-sectional study included 99 counties within 14 US states participating in the COVID-19-Associated Hospitalization Surveillance Network. Participants were persons of all ages hospitalized with COVID-19 from March 1, 2020, to February 28, 2021. Exposures Laboratory-confirmed COVID-19-associated hospitalization, defined as a positive SARS-CoV-2 test within 14 days prior to or during hospitalization. Main Outcomes andMeasures:
Cumulative age-adjusted rates (per 100â¯000 population) of hospitalization, ICU admission, and death by race and ethnicity. Rate ratios (RR) were calculated for each racial and ethnic group compared with White persons.Results:
Among 153â¯692 patients with COVID-19-associated hospitalizations, 143â¯342 (93.3%) with information on race and ethnicity were included in the analysis. Of these, 105â¯421 (73.5%) were 50 years or older, 72â¯159 (50.3%) were male, 28â¯762 (20.1%) were Hispanic or Latino, 2056 (1.4%) were non-Hispanic American Indian or Alaska Native, 7737 (5.4%) were non-Hispanic Asian or Pacific Islander, 40â¯806 (28.5%) were non-Hispanic Black, and 63â¯981 (44.6%) were White. Compared with White persons, American Indian or Alaska Native, Latino, Black, and Asian or Pacific Islander persons were more likely to have higher cumulative age-adjusted rates of hospitalization, ICU admission, and death as follows American Indian or Alaska Native (hospitalization RR, 3.70; 95% CI, 3.54-3.87; ICU admission RR, 6.49; 95% CI, 6.01-7.01; death RR, 7.19; 95% CI, 6.47-7.99); Latino (hospitalization RR, 3.06; 95% CI, 3.01-3.10; ICU admission RR, 4.20; 95% CI, 4.08-4.33; death RR, 3.85; 95% CI, 3.68-4.01); Black (hospitalization RR, 2.85; 95% CI, 2.81-2.89; ICU admission RR, 3.17; 95% CI, 3.09-3.26; death RR, 2.58; 95% CI, 2.48-2.69); and Asian or Pacific Islander (hospitalization RR, 1.03; 95% CI, 1.01-1.06; ICU admission RR, 1.91; 95% CI, 1.83-1.98; death RR, 1.64; 95% CI, 1.55-1.74). Conclusions and Relevance In this cross-sectional analysis, American Indian or Alaska Native, Latino, Black, and Asian or Pacific Islander persons were more likely than White persons to have a COVID-19-associated hospitalization, ICU admission, or in-hospital death during the first year of the US COVID-19 pandemic. Equitable access to COVID-19 preventive measures, including vaccination, is needed to minimize the gap in racial and ethnic disparities of severe COVID-19.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Hospital Mortality
/
Health Status Disparities
/
COVID-19
/
Hospitalization
/
Intensive Care Units
Type of study:
Experimental Studies
/
Observational study
/
Randomized controlled trials
Topics:
Vaccines
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
North America
Language:
English
Journal:
JAMA Netw Open
Year:
2021
Document Type:
Article
Affiliation country:
Jamanetworkopen.2021.30479
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