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Showing content from https://pubmed.ncbi.nlm.nih.gov/32827436/ below:

How Do Presenting Symptoms and Outcomes Differ by Race/Ethnicity Among Hospitalized Patients With Coronavirus Disease 2019 Infection? Experience in Massachusetts

Multicenter Study

. 2021 Dec 6;73(11):e4131-e4138. doi: 10.1093/cid/ciaa1245. How Do Presenting Symptoms and Outcomes Differ by Race/Ethnicity Among Hospitalized Patients With Coronavirus Disease 2019 Infection? Experience in Massachusetts Thomas R McCarty^{1 2 3}, Kelly E Hathorn^{1 2 3}, Nicolette J Rodriguez^{1 2 3}, Joyce C Zhou³, Ahmad Najdat Bazarbashi^{1 2 3}, Cheikh Njie^{2 3}, Danny Wong^{2 3}, Quoc-Dien Trinh^{3 4}, Lin Shen^{1 2 3}, Valerie E Stone^{2 3 5 6}, Walter W Chan^{1 2 3}

Affiliations

¹ Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
² Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
³ Harvard Medical School, Boston, Massachusetts, USA.
⁴ Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA.
⁵ Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
⁶ Division of Infectious Disease, Brigham and Women's Hospital, Boston, Massachusetts, USA.

PMID: 32827436
PMCID: PMC7499493
DOI: 10.1093/cid/ciaa1245

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Multicenter Study

How Do Presenting Symptoms and Outcomes Differ by Race/Ethnicity Among Hospitalized Patients With Coronavirus Disease 2019 Infection? Experience in Massachusetts

Thomas R McCarty et al. Clin Infect Dis. 2021.

. 2021 Dec 6;73(11):e4131-e4138. doi: 10.1093/cid/ciaa1245. Authors Thomas R McCarty^{1 2 3}, Kelly E Hathorn^{1 2 3}, Walker D Redd^{2 3}, Nicolette J Rodriguez^{1 2 3}, Joyce C Zhou³, Ahmad Najdat Bazarbashi^{1 2 3}, Cheikh Njie^{2 3}, Danny Wong^{2 3}, Quoc-Dien Trinh^{3 4}, Lin Shen^{1 2 3}, Valerie E Stone^{2 3 5 6}, Walter W Chan^{1 2 3} Affiliations

¹ Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
² Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
³ Harvard Medical School, Boston, Massachusetts, USA.
⁴ Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA.
⁵ Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
⁶ Division of Infectious Disease, Brigham and Women's Hospital, Boston, Massachusetts, USA.

PMID: 32827436
PMCID: PMC7499493
DOI: 10.1093/cid/ciaa1245

Item in Clipboard

Abstract

Background: Population-based literature suggests severe acute respiratory syndrome coronavirus 2 infection may disproportionately affect racial/ethnic minorities; however, patient-level observations of hospitalization outcomes by race/ethnicity are limited. Our aim in this study was to characterize coronavirus disease 2019 (COVID-19)-associated morbidity and in-hospital mortality by race/ethnicity.

Methods: This was a retrospective analysis of 9 Massachusetts hospitals including all consecutive adult patients hospitalized with laboratory-confirmed COVID-19. Measured outcomes were assessed and compared by patient-reported race/ethnicity, classified as white, black, Latinx, Asian, or other. Student t test, Fischer exact test, and multivariable regression analyses were performed.

Results: A total of 379 patients (aged 62.9 ± 16.5 years; 55.7% men) with confirmed COVID-19 were included (49.9% white, 13.7% black, 29.8% Latinx, 3.7% Asian), of which 376 (99.2%) were insured (34.3% private, 41.2% public, 23.8% public with supplement). Latinx patients were younger, had fewer cardiopulmonary disorders, were more likely to be obese, more frequently reported fever and myalgia, and had lower D-dimer levels compared with white patients (P < .05). On multivariable analysis controlling for age, gender, obesity, cardiopulmonary comorbidities, hypertension, and diabetes, no significant differences in in-hospital mortality, intensive care unit admission, or mechanical ventilation by race/ethnicity were found. Diabetes was a significant predictor for mechanical ventilation (odds ratio [OR], 1.89; 95% confidence interval [CI], 1.11-3.23), while older age was a predictor of in-hospital mortality (OR, 4.18; 95% CI, 1.94-9.04).

Conclusions: In this multicenter cohort of hospitalized COVID-19 patients in the largest health system in Massachusetts, there was no association between race/ethnicity and clinically relevant hospitalization outcomes, including in-hospital mortality, after controlling for key demographic/clinical characteristics. These findings serve to refute suggestions that certain races/ethnicities may be biologically predisposed to poorer COVID-19 outcomes.

Keywords: coronavirus disease 2019 (COVID-19); healthcare disparities; race/ethnicity; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

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Figures
Figure 1.

Hospitalization outcomes of patients with…

Figure 1.

Hospitalization outcomes of patients with COVID-19 infection by race/ethnicity. A, ICU admission rate…

Figure 1.

Hospitalization outcomes of patients with COVID-19 infection by race/ethnicity. A, ICU admission rate and need for mechanical ventilation. B, All-cause, in-hospital mortality rate. Abbreviations: COVID-19, coronavirus disease 2019; ICU, intensive care unit.