RetroSearch Browse

Home - News ( United States | United Kingdom | Italy | Germany ) - Football scores

Showing content from https://pubmed.ncbi.nlm.nih.gov/32975575/ below:

Racial Disparities in Incidence and Outcomes Among Patients With COVID-19

. 2020 Sep 1;3(9):e2021892. doi: 10.1001/jamanetworkopen.2020.21892. Racial Disparities in Incidence and Outcomes Among Patients With COVID-19

Affiliations

¹ Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee.
² Division of General Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee.
³ Collaborative for Healthcare Delivery Science, Medical College of Wisconsin, Milwaukee.
⁴ Froedtert Health, Milwaukee, Wisconsin.
⁵ School of Medicine, Medical College of Wisconsin, Milwaukee.
⁶ Department of Pathology, Medical College of Wisconsin, Milwaukee.
⁷ Institute for Health and Equity, Medical College of Wisconsin, Milwaukee.

PMID: 32975575
PMCID: PMC7519420
DOI: 10.1001/jamanetworkopen.2020.21892

Item in Clipboard

Racial Disparities in Incidence and Outcomes Among Patients With COVID-19

L Silvia Muñoz-Price et al. JAMA Netw Open. 2020.

. 2020 Sep 1;3(9):e2021892. doi: 10.1001/jamanetworkopen.2020.21892. Affiliations

¹ Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee.
² Division of General Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee.
³ Collaborative for Healthcare Delivery Science, Medical College of Wisconsin, Milwaukee.
⁴ Froedtert Health, Milwaukee, Wisconsin.
⁵ School of Medicine, Medical College of Wisconsin, Milwaukee.
⁶ Department of Pathology, Medical College of Wisconsin, Milwaukee.
⁷ Institute for Health and Equity, Medical College of Wisconsin, Milwaukee.

PMID: 32975575
PMCID: PMC7519420
DOI: 10.1001/jamanetworkopen.2020.21892

Item in Clipboard

Abstract

Importance: Initial public health data show that Black race may be a risk factor for worse outcomes of coronavirus disease 2019 (COVID-19).

Objective: To characterize the association of race with incidence and outcomes of COVID-19, while controlling for age, sex, socioeconomic status, and comorbidities.

Design, setting, and participants: This cross-sectional study included 2595 consecutive adults tested for COVID-19 from March 12 to March 31, 2020, at Froedtert Health and Medical College of Wisconsin (Milwaukee), the largest academic system in Wisconsin, with 879 inpatient beds (of which 128 are intensive care unit beds).

Exposures: Race (Black vs White, Native Hawaiian or Pacific Islander, Native American or Alaska Native, Asian, or unknown).

Main outcomes and measures: Main outcomes included COVID-19 positivity, hospitalization, intensive care unit admission, mechanical ventilation, and death. Additional independent variables measured and tested included socioeconomic status, sex, and comorbidities. Reverse transcription polymerase chain reaction assay was used to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Results: A total of 2595 patients were included. The mean (SD) age was 53.8 (17.5) years, 978 (37.7%) were men, and 785 (30.2%) were African American patients. Of the 369 patients (14.2%) who tested positive for COVID-19, 170 (46.1%) were men, 148 (40.1%) were aged 60 years or older, and 218 (59.1%) were African American individuals. Positive tests were associated with Black race (odds ratio [OR], 5.37; 95% CI, 3.94-7.29; P = .001), male sex (OR, 1.55; 95% CI, 1.21-2.00; P = .001), and age 60 years or older (OR, 2.04; 95% CI, 1.53-2.73; P = .001). Zip code of residence explained 79% of the overall variance in COVID-19 positivity in the cohort (ρ = 0.79; 95% CI, 0.58-0.91). Adjusting for zip code of residence, Black race (OR, 1.85; 95% CI, 1.00-3.65; P = .04) and poverty (OR, 3.84; 95% CI, 1.20-12.30; P = .02) were associated with hospitalization. Poverty (OR, 3.58; 95% CI, 1.08-11.80; P = .04) but not Black race (OR, 1.52; 95% CI, 0.75-3.07; P = .24) was associated with intensive care unit admission. Overall, 20 (17.2%) deaths associated with COVID-19 were reported. Shortness of breath at presentation (OR, 10.67; 95% CI, 1.52-25.54; P = .02), higher body mass index (OR per unit of body mass index, 1.19; 95% CI, 1.05-1.35; P = .006), and age 60 years or older (OR, 22.79; 95% CI, 3.38-53.81; P = .001) were associated with an increased likelihood of death.

Conclusions and relevance: In this cross-sectional study of adults tested for COVID-19 in a large midwestern academic health system, COVID-19 positivity was associated with Black race. Among patients with COVID-19, both race and poverty were associated with higher risk of hospitalization, but only poverty was associated with higher risk of intensive care unit admission. These findings can be helpful in targeting mitigation strategies for racial disparities in the incidence and outcomes of COVID-19.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Nattinger reported receiving grants from the National Institutes of Health and the Advancing Healthier Wisconsin Endowment outside the submitted work. Dr Singh reported receiving consulting fees from Astra Zeneca outside the submitted work. Dr Buchan reported receiving grants and personal fees from BioFire Diagnostics outside the submitted work. No other disclosures were reported.

Figures
Figure.. Distribution of Coronavirus Disease 2019 (COVID-19)…

Figure.. Distribution of Coronavirus Disease 2019 (COVID-19) Cases Based on Socioeconomically Disadvantaged Zip Codes in…
Figure.. Distribution of Coronavirus Disease 2019 (COVID-19) Cases Based on Socioeconomically Disadvantaged Zip Codes in Milwaukee, Wisconsin

Patient postal codes were mapped using blur and jitter to maintain confidentiality and were categorized based on COVID-19 test results. Socially disadvantaged areas are defined as those 9-digit zip codes with a score of 7 or higher in the Area Deprivation Index. Map created using Excel 2016 3D Maps (Microsoft Corp).