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Showing content from https://pubmed.ncbi.nlm.nih.gov/32784264/ below:

Racial and ethnic disparities in SARS-CoV-2 pandemic: analysis of a COVID-19 observational registry for a diverse US metropolitan population

Observational Study

. 2020 Aug 11;10(8):e039849. doi: 10.1136/bmjopen-2020-039849. Racial and ethnic disparities in SARS-CoV-2 pandemic: analysis of a COVID-19 observational registry for a diverse US metropolitan population Juan Carlos Nicolas³, Jennifer R Meeks³, Osman Khan³, Alan Pan³, Stephen L Jones^{3 4 5}, Faisal Masud^{4 6}, H Dirk Sostman^{4 7 8}, Robert Phillips^{3 4 9}, Julia D Andrieni^{4 10}, Bita A Kash^{3 4 11}, Khurram Nasir^{3 9}

Affiliations

¹ Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas, USA fvahidy@houstonmethodist.org.
² Houston Methodist Neurological Institute, Houston, Texas, USA.
³ Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas, USA.
⁴ Weill Cornell Medicine, New York, New York, USA.
⁵ Department of Surgery, Houston Methodist Hospital, Houston, TX, United States.
⁶ Department of Anesthesiology and Critical Care, Houston Methodist Hospital, Houston, TX, United States.
⁷ Houston Methodist Research Institute, Houston, Texas, USA.
⁸ Houston Methodist Academic Institute, Houston, TX, United States.
⁹ Department of Cardiology, DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, United States.
¹⁰ Department of Medicine, Houston Methodist Hospital, Houston, TX, United States.
¹¹ Texas A&M University School of Rural Public Health, College Station, Texas, USA.

PMID: 32784264
PMCID: PMC7418666
DOI: 10.1136/bmjopen-2020-039849

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Observational Study

Racial and ethnic disparities in SARS-CoV-2 pandemic: analysis of a COVID-19 observational registry for a diverse US metropolitan population

Farhaan S Vahidy et al. BMJ Open. 2020.

. 2020 Aug 11;10(8):e039849. doi: 10.1136/bmjopen-2020-039849. Authors Farhaan S Vahidy^{1 2}, Juan Carlos Nicolas³, Jennifer R Meeks³, Osman Khan³, Alan Pan³, Stephen L Jones^{3 4 5}, Faisal Masud^{4 6}, H Dirk Sostman^{4 7 8}, Robert Phillips^{3 4 9}, Julia D Andrieni^{4 10}, Bita A Kash^{3 4 11}, Khurram Nasir^{3 9} Affiliations

¹ Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas, USA fvahidy@houstonmethodist.org.
² Houston Methodist Neurological Institute, Houston, Texas, USA.
³ Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas, USA.
⁴ Weill Cornell Medicine, New York, New York, USA.
⁵ Department of Surgery, Houston Methodist Hospital, Houston, TX, United States.
⁶ Department of Anesthesiology and Critical Care, Houston Methodist Hospital, Houston, TX, United States.
⁷ Houston Methodist Research Institute, Houston, Texas, USA.
⁸ Houston Methodist Academic Institute, Houston, TX, United States.
⁹ Department of Cardiology, DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, United States.
¹⁰ Department of Medicine, Houston Methodist Hospital, Houston, TX, United States.
¹¹ Texas A&M University School of Rural Public Health, College Station, Texas, USA.

PMID: 32784264
PMCID: PMC7418666
DOI: 10.1136/bmjopen-2020-039849

Item in Clipboard

Abstract

Introduction: Data on race and ethnic disparities for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are limited. We analysed sociodemographic factors associated with higher likelihood of SARS-CoV-2 infection and explore mediating pathways for race and ethnic disparities in the SARS-CoV-2 pandemic.

Methods: This is a cross-sectional analysis of the COVID-19 Surveillance and Outcomes Registry, which captures data for a large healthcare system, comprising one central tertiary care hospital, seven large community hospitals and an expansive ambulatory/emergency care network in the Greater Houston area. Nasopharyngeal samples for individuals inclusive of all ages, races, ethnicities and sex were tested for SARS-CoV-2. We analysed sociodemographic (age, sex, race, ethnicity, household income, residence population density) and comorbidity (Charlson Comorbidity Index, hypertension, diabetes, obesity) factors. Multivariable logistic regression models were fitted to provide adjusted OR (aOR) and 95% CI for likelihood of a positive SARS-CoV-2 test. Structural equation modelling (SEM) framework was used to explore three mediation pathways (low income, high population density, high comorbidity burden) for the association between non-Hispanic black (NHB) race, Hispanic ethnicity and SARS-CoV-2 infection.

Results: Among 20 228 tested individuals, 1551 (7.7%) tested positive. The overall mean (SD) age was 51.1 (19.0) years, 62% were females, 22% were black and 18% were Hispanic. NHB and Hispanic ethnicity were associated with lower socioeconomic status and higher population density residence. In the fully adjusted model, NHB (vs non-Hispanic white; aOR, 2.23, CI 1.90 to 2.60) and Hispanic ethnicity (vs non-Hispanic; aOR, 1.95, CI 1.72 to 2.20) had a higher likelihood of infection. Older individuals and males were also at higher risk of infection. The SEM framework demonstrated a significant indirect effect of NHB and Hispanic ethnicity on SARS-CoV-2 infection mediated via a pathway including residence in densely populated zip code.

Conclusions: There is strong evidence of race and ethnic disparities in the SARS-CoV-2 pandemic that are potentially mediated through unique social determinants of health.

Keywords: epidemiology; infectious diseases; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures
Figure 1

Adjusted probability and 95% CI…

Figure 1

Adjusted probability and 95% CI of positive SARS-CoV-2 PCR in non-Hispanic black versus…

Figure 1

Adjusted probability and 95% CI of positive SARS-CoV-2 PCR in non-Hispanic black versus non-Hispanic white by increasing age. SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.

Figure 2

Adjusted probability and 95% CI…

Figure 2

Adjusted probability and 95% CI of positive SARS-CoV-2 PCR in Hispanic versus non-Hispanic…

Figure 2

Adjusted probability and 95% CI of positive SARS-CoV-2 PCR in Hispanic versus non-Hispanic by increasing age. SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.