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Critical Care Among Disadvantaged Minority Groups Made Equitable: Trends Throughout the COVID-19 Pandemic.
Lopez, Diana Cristina; Whelan, Georgina; Kojima, Lisa; Dore, Samyukta; Lad, Saloni; Tucker, Dominique; Abramczyk, Emily; Mehkri, Omar; Han, Xiaozhen; Wang, Xiaofeng; Yepes-Rios, Ana Monica; Duggal, Abhijit.
  • Lopez DC; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
  • Whelan G; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
  • Kojima L; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
  • Dore S; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
  • Lad S; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
  • Tucker D; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
  • Abramczyk E; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
  • Mehkri O; Department of Critical Care, Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, OH, 44195, Cleveland, USA.
  • Han X; Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
  • Wang X; Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
  • Yepes-Rios AM; Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.
  • Duggal A; Department of Critical Care, Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, OH, 44195, Cleveland, USA. duggala2@ccf.org.
J Racial Ethn Health Disparities ; 2022 Feb 04.
Article in English | MEDLINE | ID: covidwho-2269641
ABSTRACT

BACKGROUND:

US racial and ethnic minorities have well-established elevated rates of comorbidities, which, compounded with healthcare access inequity, often lead to worse health outcomes. In the current COVID-19 pandemic, it is important to understand existing disparities in minority groups' critical care outcomes and mechanisms behind these-topics that have yet to be well-explored.

OBJECTIVE:

Assess for disparities in racial and ethnic minority groups' COVID-19 critical care outcomes.

DESIGN:

Retrospective cohort study.

PARTICIPANTS:

A total of 2125 adult patients who tested positive for COVID-19 via RT-PCR between March and December 2020 and required ICU admission at the Cleveland Clinic Hospital Systems were included. MAIN

MEASURES:

Primary outcomes were mortality and hospital length of stay. Cohort-wide analysis and subgroup analyses by pandemic wave were performed. Multivariable logistic regression models were built to study the associations between mortality and covariates. KEY

RESULTS:

While crude mortality was increased in White as compared to Black patients (37.5% vs. 30.5%, respectively; p = 0.002), no significant differences were appraised after adjustment or across pandemic waves. Although median hospital length of stay was comparable between these groups, ICU stay was significantly different (4.4 vs. 3.4, p = 0.003). Mortality and median hospital and ICU length of stay did not differ significantly between Hispanic and non-Hispanic patients. Neither race nor ethnicity was associated with mortality due to COVID-19, although APACHE score, CKD, malignant neoplasms, antibiotic use, vasopressor requirement, and age were.

CONCLUSIONS:

We found no significant differences in mortality or hospital length of stay between different races and ethnicities. In a pandemic-influenced critical care setting that operated outside conditions of ICU strain and implemented standardized protocol enabling equitable resource distribution, disparities in outcomes often seen among racial and ethnic minority groups were successfully mitigated.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Year: 2022 Document Type: Article Affiliation country: S40615-022-01254-1

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Year: 2022 Document Type: Article Affiliation country: S40615-022-01254-1