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Clinical Characteristics and Outcomes Based on Race of Hospitalized Patients With COVID-19 in a New Orleans Cohort

BACKGROUND: In Louisiana, deaths related to COVID-19 have disproportionately occurred in Black persons. Granular data are needed to better understand inequities and develop prevention strategies to mitigate further impact on Black communities. METHODS: We conducted a retrospective study of patients...

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Autores principales: Silver, Victoria, Chapple, Andrew G, Feibus, Allison H, Beckford, Jeremy, Halapin, Natalie A, Barua, Delphi, Gordon, Angellica, Baumgartner, Will, Vignes, Seth, Clark, Cullen, Kamboj, Sanjay, Lim, Stephen C, Mackey, Scott P, Seal, Paula S, Kanter, Joseph M, Bell, Caryn, Clement, Meredith E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7454836/
https://www.ncbi.nlm.nih.gov/pubmed/32884965
http://dx.doi.org/10.1093/ofid/ofaa339
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author Silver, Victoria
Chapple, Andrew G
Feibus, Allison H
Beckford, Jeremy
Halapin, Natalie A
Barua, Delphi
Gordon, Angellica
Baumgartner, Will
Vignes, Seth
Clark, Cullen
Kamboj, Sanjay
Lim, Stephen C
Mackey, Scott P
Seal, Paula S
Kanter, Joseph M
Bell, Caryn
Clement, Meredith E
author_facet Silver, Victoria
Chapple, Andrew G
Feibus, Allison H
Beckford, Jeremy
Halapin, Natalie A
Barua, Delphi
Gordon, Angellica
Baumgartner, Will
Vignes, Seth
Clark, Cullen
Kamboj, Sanjay
Lim, Stephen C
Mackey, Scott P
Seal, Paula S
Kanter, Joseph M
Bell, Caryn
Clement, Meredith E
author_sort Silver, Victoria
collection PubMed
description BACKGROUND: In Louisiana, deaths related to COVID-19 have disproportionately occurred in Black persons. Granular data are needed to better understand inequities and develop prevention strategies to mitigate further impact on Black communities. METHODS: We conducted a retrospective study of patients admitted to an urban safety net hospital in New Orleans, Louisiana, with reactive SARS-CoV-2 testing from March 9 to 31, 2020. Clinical characteristics of Black and other racial/ethnic group patients were compared using Wilcoxon rank-sum test and Fisher exact tests. The relationship between race and outcome was assessed using day 14 status on an ordinal scale. RESULTS: This study included 249 patients. The median age was 59, 44% were male, and 86% were age ≥65 years or had ≥1 comorbidity. Overall, 87% were Black, relative to 55% Black patients typically hospitalized at our center. Black patients had longer symptom duration at presentation (6.41 vs 5.88 days; P = .05) and were more likely to have asthma (P = .008) but less likely to have dementia (P = .002). There were no racial differences in initial respiratory status or laboratory values except for higher lactate dehydrogenase in Black patients. Patient age and initial oxygen requirement, but not race (adjusted proportional odds ratio, 0.92; 95% CI, 0.70–1.20), were associated with worse day 14 outcomes. CONCLUSIONS: Our results demonstrate minor racial differences in comorbidities or disease severity at presentation, and day 14 outcomes were not different between groups. However, Black patients were disproportionately represented in hospitalizations, suggesting that prevention efforts should include strategies to limit SARS-CoV-2 exposures and transmission in Black communities as one step toward reducing COVID-19-related racial inequities.
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spelling pubmed-74548362020-08-31 Clinical Characteristics and Outcomes Based on Race of Hospitalized Patients With COVID-19 in a New Orleans Cohort Silver, Victoria Chapple, Andrew G Feibus, Allison H Beckford, Jeremy Halapin, Natalie A Barua, Delphi Gordon, Angellica Baumgartner, Will Vignes, Seth Clark, Cullen Kamboj, Sanjay Lim, Stephen C Mackey, Scott P Seal, Paula S Kanter, Joseph M Bell, Caryn Clement, Meredith E Open Forum Infect Dis Major Articles BACKGROUND: In Louisiana, deaths related to COVID-19 have disproportionately occurred in Black persons. Granular data are needed to better understand inequities and develop prevention strategies to mitigate further impact on Black communities. METHODS: We conducted a retrospective study of patients admitted to an urban safety net hospital in New Orleans, Louisiana, with reactive SARS-CoV-2 testing from March 9 to 31, 2020. Clinical characteristics of Black and other racial/ethnic group patients were compared using Wilcoxon rank-sum test and Fisher exact tests. The relationship between race and outcome was assessed using day 14 status on an ordinal scale. RESULTS: This study included 249 patients. The median age was 59, 44% were male, and 86% were age ≥65 years or had ≥1 comorbidity. Overall, 87% were Black, relative to 55% Black patients typically hospitalized at our center. Black patients had longer symptom duration at presentation (6.41 vs 5.88 days; P = .05) and were more likely to have asthma (P = .008) but less likely to have dementia (P = .002). There were no racial differences in initial respiratory status or laboratory values except for higher lactate dehydrogenase in Black patients. Patient age and initial oxygen requirement, but not race (adjusted proportional odds ratio, 0.92; 95% CI, 0.70–1.20), were associated with worse day 14 outcomes. CONCLUSIONS: Our results demonstrate minor racial differences in comorbidities or disease severity at presentation, and day 14 outcomes were not different between groups. However, Black patients were disproportionately represented in hospitalizations, suggesting that prevention efforts should include strategies to limit SARS-CoV-2 exposures and transmission in Black communities as one step toward reducing COVID-19-related racial inequities. Oxford University Press 2020-08-13 /pmc/articles/PMC7454836/ /pubmed/32884965 http://dx.doi.org/10.1093/ofid/ofaa339 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Articles
Silver, Victoria
Chapple, Andrew G
Feibus, Allison H
Beckford, Jeremy
Halapin, Natalie A
Barua, Delphi
Gordon, Angellica
Baumgartner, Will
Vignes, Seth
Clark, Cullen
Kamboj, Sanjay
Lim, Stephen C
Mackey, Scott P
Seal, Paula S
Kanter, Joseph M
Bell, Caryn
Clement, Meredith E
Clinical Characteristics and Outcomes Based on Race of Hospitalized Patients With COVID-19 in a New Orleans Cohort
title Clinical Characteristics and Outcomes Based on Race of Hospitalized Patients With COVID-19 in a New Orleans Cohort
title_full Clinical Characteristics and Outcomes Based on Race of Hospitalized Patients With COVID-19 in a New Orleans Cohort
title_fullStr Clinical Characteristics and Outcomes Based on Race of Hospitalized Patients With COVID-19 in a New Orleans Cohort
title_full_unstemmed Clinical Characteristics and Outcomes Based on Race of Hospitalized Patients With COVID-19 in a New Orleans Cohort
title_short Clinical Characteristics and Outcomes Based on Race of Hospitalized Patients With COVID-19 in a New Orleans Cohort
title_sort clinical characteristics and outcomes based on race of hospitalized patients with covid-19 in a new orleans cohort
topic Major Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7454836/
https://www.ncbi.nlm.nih.gov/pubmed/32884965
http://dx.doi.org/10.1093/ofid/ofaa339
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