Cargando…

Racial differences in COVID-19 severity associated with history of substance use disorders and overdose: Findings from multi-site electronic health records in New York City

Substance use disorders (SUD) are associated with increased risk of worse COVID-19 outcomes. Likewise, racial/ethnic minority patients experience greater risk of severe COVID-19 disease compared to white patients. Providers should understand the role of race and ethnicity as an effect modifier on CO...

Descripción completa

Detalles Bibliográficos
Autores principales: Allen, Bennett, Basaraba, Cale, Corbeil, Thomas, Rivera, Bianca D., Levin, Frances R., Martinez, Diana M., Schultebraucks, Katharina, Henry, Brandy F., Pincus, Harold A., Arout, Caroline, Krawczyk, Noa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155467/
https://www.ncbi.nlm.nih.gov/pubmed/37146730
http://dx.doi.org/10.1016/j.ypmed.2023.107533
_version_ 1785036334634631168
author Allen, Bennett
Basaraba, Cale
Corbeil, Thomas
Rivera, Bianca D.
Levin, Frances R.
Martinez, Diana M.
Schultebraucks, Katharina
Henry, Brandy F.
Pincus, Harold A.
Arout, Caroline
Krawczyk, Noa
author_facet Allen, Bennett
Basaraba, Cale
Corbeil, Thomas
Rivera, Bianca D.
Levin, Frances R.
Martinez, Diana M.
Schultebraucks, Katharina
Henry, Brandy F.
Pincus, Harold A.
Arout, Caroline
Krawczyk, Noa
author_sort Allen, Bennett
collection PubMed
description Substance use disorders (SUD) are associated with increased risk of worse COVID-19 outcomes. Likewise, racial/ethnic minority patients experience greater risk of severe COVID-19 disease compared to white patients. Providers should understand the role of race and ethnicity as an effect modifier on COVID-19 severity among individuals with SUD. This retrospective cohort study assessed patient race/ethnicity as an effect modifier of the risk of severe COVID-19 disease among patients with histories of SUD and overdose. We used merged electronic health record data from 116,471 adult patients with a COVID-19 encounter between March 2020 and February 2021 across five healthcare systems in New York City. Exposures were patient histories of SUD and overdose. Outcomes were risk of COVID-19 hospitalization and subsequent COVID-19-related ventilation, acute kidney failure, sepsis, and mortality. Risk factors included patient age, sex, and race/ethnicity, as well as medical comorbidities associated with COVID-19 severity. We tested for interaction between SUD and patient race/ethnicity on COVID-19 outcomes. Findings showed that Non-Hispanic Black, Hispanic/Latino, and Asian/Pacific Islander patients experienced a higher prevalence of all adverse COVID-19 outcomes compared to non-Hispanic white patients. Past-year alcohol (OR 1.24 [1.01–1.53]) and opioid use disorders (OR 1.91 [1.46–2.49]), as well as overdose history (OR 4.45 [3.62–5.46]), were predictive of COVID-19 mortality, as well as other adverse COVID-19 outcomes. Among patients with SUD, significant differences in outcome risk were detected between patients of different race/ethnicity groups. Findings indicate that providers should consider multiple dimensions of vulnerability to adequately manage COVID-19 disease among populations with SUDs.
format Online
Article
Text
id pubmed-10155467
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Elsevier Inc.
record_format MEDLINE/PubMed
spelling pubmed-101554672023-05-04 Racial differences in COVID-19 severity associated with history of substance use disorders and overdose: Findings from multi-site electronic health records in New York City Allen, Bennett Basaraba, Cale Corbeil, Thomas Rivera, Bianca D. Levin, Frances R. Martinez, Diana M. Schultebraucks, Katharina Henry, Brandy F. Pincus, Harold A. Arout, Caroline Krawczyk, Noa Prev Med Article Substance use disorders (SUD) are associated with increased risk of worse COVID-19 outcomes. Likewise, racial/ethnic minority patients experience greater risk of severe COVID-19 disease compared to white patients. Providers should understand the role of race and ethnicity as an effect modifier on COVID-19 severity among individuals with SUD. This retrospective cohort study assessed patient race/ethnicity as an effect modifier of the risk of severe COVID-19 disease among patients with histories of SUD and overdose. We used merged electronic health record data from 116,471 adult patients with a COVID-19 encounter between March 2020 and February 2021 across five healthcare systems in New York City. Exposures were patient histories of SUD and overdose. Outcomes were risk of COVID-19 hospitalization and subsequent COVID-19-related ventilation, acute kidney failure, sepsis, and mortality. Risk factors included patient age, sex, and race/ethnicity, as well as medical comorbidities associated with COVID-19 severity. We tested for interaction between SUD and patient race/ethnicity on COVID-19 outcomes. Findings showed that Non-Hispanic Black, Hispanic/Latino, and Asian/Pacific Islander patients experienced a higher prevalence of all adverse COVID-19 outcomes compared to non-Hispanic white patients. Past-year alcohol (OR 1.24 [1.01–1.53]) and opioid use disorders (OR 1.91 [1.46–2.49]), as well as overdose history (OR 4.45 [3.62–5.46]), were predictive of COVID-19 mortality, as well as other adverse COVID-19 outcomes. Among patients with SUD, significant differences in outcome risk were detected between patients of different race/ethnicity groups. Findings indicate that providers should consider multiple dimensions of vulnerability to adequately manage COVID-19 disease among populations with SUDs. Elsevier Inc. 2023-07 2023-05-03 /pmc/articles/PMC10155467/ /pubmed/37146730 http://dx.doi.org/10.1016/j.ypmed.2023.107533 Text en © 2023 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Allen, Bennett
Basaraba, Cale
Corbeil, Thomas
Rivera, Bianca D.
Levin, Frances R.
Martinez, Diana M.
Schultebraucks, Katharina
Henry, Brandy F.
Pincus, Harold A.
Arout, Caroline
Krawczyk, Noa
Racial differences in COVID-19 severity associated with history of substance use disorders and overdose: Findings from multi-site electronic health records in New York City
title Racial differences in COVID-19 severity associated with history of substance use disorders and overdose: Findings from multi-site electronic health records in New York City
title_full Racial differences in COVID-19 severity associated with history of substance use disorders and overdose: Findings from multi-site electronic health records in New York City
title_fullStr Racial differences in COVID-19 severity associated with history of substance use disorders and overdose: Findings from multi-site electronic health records in New York City
title_full_unstemmed Racial differences in COVID-19 severity associated with history of substance use disorders and overdose: Findings from multi-site electronic health records in New York City
title_short Racial differences in COVID-19 severity associated with history of substance use disorders and overdose: Findings from multi-site electronic health records in New York City
title_sort racial differences in covid-19 severity associated with history of substance use disorders and overdose: findings from multi-site electronic health records in new york city
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155467/
https://www.ncbi.nlm.nih.gov/pubmed/37146730
http://dx.doi.org/10.1016/j.ypmed.2023.107533
work_keys_str_mv AT allenbennett racialdifferencesincovid19severityassociatedwithhistoryofsubstanceusedisordersandoverdosefindingsfrommultisiteelectronichealthrecordsinnewyorkcity
AT basarabacale racialdifferencesincovid19severityassociatedwithhistoryofsubstanceusedisordersandoverdosefindingsfrommultisiteelectronichealthrecordsinnewyorkcity
AT corbeilthomas racialdifferencesincovid19severityassociatedwithhistoryofsubstanceusedisordersandoverdosefindingsfrommultisiteelectronichealthrecordsinnewyorkcity
AT riverabiancad racialdifferencesincovid19severityassociatedwithhistoryofsubstanceusedisordersandoverdosefindingsfrommultisiteelectronichealthrecordsinnewyorkcity
AT levinfrancesr racialdifferencesincovid19severityassociatedwithhistoryofsubstanceusedisordersandoverdosefindingsfrommultisiteelectronichealthrecordsinnewyorkcity
AT martinezdianam racialdifferencesincovid19severityassociatedwithhistoryofsubstanceusedisordersandoverdosefindingsfrommultisiteelectronichealthrecordsinnewyorkcity
AT schultebrauckskatharina racialdifferencesincovid19severityassociatedwithhistoryofsubstanceusedisordersandoverdosefindingsfrommultisiteelectronichealthrecordsinnewyorkcity
AT henrybrandyf racialdifferencesincovid19severityassociatedwithhistoryofsubstanceusedisordersandoverdosefindingsfrommultisiteelectronichealthrecordsinnewyorkcity
AT pincusharolda racialdifferencesincovid19severityassociatedwithhistoryofsubstanceusedisordersandoverdosefindingsfrommultisiteelectronichealthrecordsinnewyorkcity
AT aroutcaroline racialdifferencesincovid19severityassociatedwithhistoryofsubstanceusedisordersandoverdosefindingsfrommultisiteelectronichealthrecordsinnewyorkcity
AT krawczyknoa racialdifferencesincovid19severityassociatedwithhistoryofsubstanceusedisordersandoverdosefindingsfrommultisiteelectronichealthrecordsinnewyorkcity