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Racial/Ethnic Disparities in Post-acute Sequelae of SARS-CoV-2 Infection in New York: an EHR-Based Cohort Study from the RECOVER Program.
Khullar, Dhruv; Zhang, Yongkang; Zang, Chengxi; Xu, Zhenxing; Wang, Fei; Weiner, Mark G; Carton, Thomas W; Rothman, Russell L; Block, Jason P; Kaushal, Rainu.
  • Khullar D; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA. khd9010@med.cornell.edu.
  • Zhang Y; Department of Medicine, Weill Cornell Medicine, New York, NY, USA. khd9010@med.cornell.edu.
  • Zang C; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
  • Xu Z; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
  • Wang F; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
  • Weiner MG; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
  • Carton TW; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
  • Rothman RL; Louisiana Public Health Institute, New Orleans, LA, USA.
  • Block JP; Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Kaushal R; Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, USA.
J Gen Intern Med ; 38(5): 1127-1136, 2023 04.
Article in English | MEDLINE | ID: covidwho-2266306
ABSTRACT

BACKGROUND:

Compared to white individuals, Black and Hispanic individuals have higher rates of COVID-19 hospitalization and death. Less is known about racial/ethnic differences in post-acute sequelae of SARS-CoV-2 infection (PASC).

OBJECTIVE:

Examine racial/ethnic differences in potential PASC symptoms and conditions among hospitalized and non-hospitalized COVID-19 patients.

DESIGN:

Retrospective cohort study using data from electronic health records.

PARTICIPANTS:

62,339 patients with COVID-19 and 247,881 patients without COVID-19 in New York City between March 2020 and October 2021. MAIN

MEASURES:

New symptoms and conditions 31-180 days after COVID-19 diagnosis. KEY

RESULTS:

The final study population included 29,331 white patients (47.1%), 12,638 Black patients (20.3%), and 20,370 Hispanic patients (32.7%) diagnosed with COVID-19. After adjusting for confounders, significant racial/ethnic differences in incident symptoms and conditions existed among both hospitalized and non-hospitalized patients. For example, 31-180 days after a positive SARS-CoV-2 test, hospitalized Black patients had higher odds of being diagnosed with diabetes (adjusted odds ratio [OR] 1.96, 95% confidence interval [CI] 1.50-2.56, q<0.001) and headaches (OR 1.52, 95% CI 1.11-2.08, q=0.02), compared to hospitalized white patients. Hospitalized Hispanic patients had higher odds of headaches (OR 1.62, 95% CI 1.21-2.17, q=0.003) and dyspnea (OR 1.22, 95% CI 1.05-1.42, q=0.02), compared to hospitalized white patients. Among non-hospitalized patients, Black patients had higher odds of being diagnosed with pulmonary embolism (OR 1.68, 95% CI 1.20-2.36, q=0.009) and diabetes (OR 2.13, 95% CI 1.75-2.58, q<0.001), but lower odds of encephalopathy (OR 0.58, 95% CI 0.45-0.75, q<0.001), compared to white patients. Hispanic patients had higher odds of being diagnosed with headaches (OR 1.41, 95% CI 1.24-1.60, q<0.001) and chest pain (OR 1.50, 95% CI 1.35-1.67, q < 0.001), but lower odds of encephalopathy (OR 0.64, 95% CI 0.51-0.80, q<0.001).

CONCLUSIONS:

Compared to white patients, patients from racial/ethnic minority groups had significantly different odds of developing potential PASC symptoms and conditions. Future research should examine the reasons for these differences.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Brain Diseases / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Country/Region as subject: North America Language: English Journal: J Gen Intern Med Journal subject: Internal Medicine Year: 2023 Document Type: Article Affiliation country: S11606-022-07997-1

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Brain Diseases / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Country/Region as subject: North America Language: English Journal: J Gen Intern Med Journal subject: Internal Medicine Year: 2023 Document Type: Article Affiliation country: S11606-022-07997-1