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Differences in Inflammation, Treatment, and Outcomes Between Black and Non-Black Patients Hospitalized for COVID-19: A Prospective Cohort Study.
Azam, Tariq U; Berlin, Hanna; Anderson, Elizabeth; Pan, Michael; Shadid, Husam R; Padalia, Kishan; O'Hayer, Patrick; Meloche, Chelsea; Feroze, Rafey; Michaud, Erinleigh; Launius, Christopher; Blakely, Penelope; Bitar, Abbas; Willer, Cristen; Pop-Busui, Rodica; Carethers, John M; Hayek, Salim S.
  • Azam TU; Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor.
  • Berlin H; University of Michigan Medical School, Ann Arbor.
  • Anderson E; Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor.
  • Pan M; Department of Internal Medicine, University of Michigan, Ann Arbor.
  • Shadid HR; Department of Internal Medicine, University of Michigan, Ann Arbor.
  • Padalia K; Department of Internal Medicine, University of Michigan, Ann Arbor.
  • O'Hayer P; Department of Internal Medicine, University of Michigan, Ann Arbor.
  • Meloche C; Department of Internal Medicine, University of Michigan, Ann Arbor.
  • Feroze R; Department of Internal Medicine, University of Michigan, Ann Arbor.
  • Michaud E; Department of Internal Medicine, University of Michigan, Ann Arbor.
  • Launius C; Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor.
  • Blakely P; Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor.
  • Bitar A; Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor.
  • Willer C; Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor.
  • Pop-Busui R; Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.
  • Carethers JM; Division of Gastroenterology & Hepatology, Department of Internal Medicine and Department of Human Genetics, University of Michigan, Ann Arbor.
  • Hayek SS; Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor. Electronic address: shayek@med.umich.edu.
Am J Med ; 135(3): 360-368, 2022 03.
Article in English | MEDLINE | ID: covidwho-1520668
ABSTRACT

PURPOSE:

Racial disparities in coronavirus disease 2019 (COVID-19) outcomes have been described. We sought to determine whether differences in inflammatory markers, use of COVID-19 therapies, enrollment in clinical trials, and in-hospital outcomes contribute to racial disparities between Black and non-Black patients hospitalized for COVID-19.

METHODS:

We leveraged a prospective cohort study that enrolled 1325 consecutive patients hospitalized for COVID-19, of whom 341 (25.7%) were Black. We measured biomarkers of inflammation and collected data on the use COVID-19-directed therapies, enrollment in COVID-19 clinical trials, mortality, need for renal replacement therapy, and need for mechanical ventilation.

RESULTS:

Compared to non-Black patients, Black patients had a higher prevalence of COVID-19 risk factors including obesity, hypertension, and diabetes mellitus and were more likely to require renal replacement therapy (15.8% vs 7.1%, P < .001) and mechanical ventilation (37.2% vs 26.6%, P < .001) during their hospitalization. Mortality was similar between both groups (15.5% for Blacks vs 14.0% for non-Blacks, P = .49). Black patients were less likely to receive corticosteroids (44.9% vs 63.8%, P< .001) or remdesivir (23.8% vs 57.8%, P < .001) and were less likely to be enrolled in COVID-19 clinical trials (15.3% vs 28.2%, P < .001). In adjusted analyses, Black race was associated with lower levels of C-reactive protein and soluble urokinase receptor and higher odds of death, mechanical ventilation, and renal replacement therapy. Differences in outcomes were not significant after adjusting for use of remdesivir and corticosteroids.

CONCLUSIONS:

Racial differences in outcomes of patients with COVID-19 may be related to differences in inflammatory response and differential use of therapies.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Black or African American / COVID-19 / Inflammation Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Am J Med Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Black or African American / COVID-19 / Inflammation Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Am J Med Year: 2022 Document Type: Article