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Showing content from https://pubmed.ncbi.nlm.nih.gov/32838233/ below:

The association of race and COVID-19 mortality

Affiliations

• ¹ Department of Medicine, Renal Division, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, United States.
• ² Departments of Oncology and Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY.
• ³ Department of Pathology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, United States.
• ⁴ Division of General Internal Medicine and Nephrology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, United States.
• ⁵ Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, NY, United States.
• ⁶ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States.
• ⁷ Department of Epidemiology and Population Health and Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx NY, United States.

• PMID: 32838233
• PMCID: PMC7361093
• DOI: 10.1016/j.eclinm.2020.100455

Item in Clipboard

Ladan Golestaneh et al. EClinicalMedicine. 2020 Aug.

• ¹ Department of Medicine, Renal Division, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, United States.
• ² Departments of Oncology and Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY.
• ³ Department of Pathology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, United States.
• ⁴ Division of General Internal Medicine and Nephrology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, United States.
• ⁵ Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, NY, United States.
• ⁶ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States.
• ⁷ Department of Epidemiology and Population Health and Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx NY, United States.

• PMID: 32838233
• PMCID: PMC7361093
• DOI: 10.1016/j.eclinm.2020.100455

Item in Clipboard

Background: COVID-19 mortality disproportionately affects the Black population in the United States (US). To explore this association a cohort study was undertaken.

Methods: We assembled a cohort of 505,992 patients receiving ambulatory care at Bronx Montefiore Health System (BMHS) between 1/1/18 and 1/1/20 to evaluate the relative risk of hospitalization and death in two time-periods, the pre-COVID time-period (1/1/20-2/15/20) and COVID time-period (3/1/20-4/15/20). COVID testing, hospitalization and mortality were determined with the Black and Hispanic patient population compared separately to the White population using logistic modeling. Evaluation of the interaction of pre-COVID and COVID time periods and race, with respect to mortality was completed.

Findings: A total of 9,286/505,992 (1.8%) patients were hospitalized during either or both pre-COVID or COVID periods. Compared to Whites the relative risk of hospitalization of Black patients did not increase in the COVID period (p for interaction=0.12). In the pre- COVID period, compared to Whites, the odds of death for Blacks and Hispanics adjusted for comorbidity was statistically equivalent. In the COVID period compared to Whites the adjusted odds of death for Blacks was 1.6 (95% CI 1.2-2.0, p = 0.001). There was a significant increase in Black mortality risk from pre-COVID to COVID periods (p for interaction=0.02). Adjustment for relevant clinical and social indices attenuated but did not fully explain the observed difference in Black mortality.

Interpretation: The BMHS COVID experience demonstrates that Blacks do have a higher mortality with COVID incompletely explained by age, multiple reported comorbidities and available metrics of sociodemographic disparity.

Funding: N/A.

Keywords: Covid; Disparity; Hospitalization; Mortality; Race.

© 2020 The Authors.

PubMed Disclaimer

Dr. Golestaneh, Dr. Perez, Dr. Norris and Dr. Johns report funding by the NIH outside of the work. The other authors declare no conflict of interest with respect to the content of this manuscript.

Conceptual Model of Potential Drivers…

Conceptual Model of Potential Drivers of Disproportionate COVID-Mortality in the Black Population.

Conceptual Model of Potential Drivers of Disproportionate COVID-Mortality in the Black Population.

Mortality Interaction Effect by Race…

Mortality Interaction Effect by Race (p for interaction for Blacks=0.02); (timeperiod 1=pre-COVID, timeperiod2-COVID).

Mortality Interaction Effect by Race (p for interaction for Blacks=0.02); (timeperiod 1=pre-COVID, timeperiod2-COVID).

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• Racial disparities in COVID-19 outcomes exist despite comparable Elixhauser comorbidity indices between Blacks, Hispanics, Native Americans, and Whites.

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