• Clin. Infect. Dis. · Aug 2020

    How Do Presenting Symptoms and Outcomes Differ by Race/Ethnicity Among Hospitalized Patients with COVID-19 Infection? Experience in Massachusetts.

    • Thomas R McCarty, Kelly E Hathorn, Walker D Redd, Nicolette J Rodriguez, Joyce C Zhou, Ahmad Najdat Bazarbashi, Cheikh Njie, Danny Wong, Quoc-Dien Trinh, Lin Shen, Valerie E Stone, and Walter W Chan.
    • Division of Gastroenterology, Hepatology and Endoscopy. Brigham and Women's Hospital, Boston, MA.
    • Clin. Infect. Dis. 2020 Aug 22.

    BackgroundPopulation-based literature suggest SARS-CoV-2 infection may disproportionately affect racial/ethnic minorities; however, patient-level observations of hospitalization outcomes by race/ethnicity are limited. The aim of this study was to characterize COVID-19-associated morbidity and in-hospital mortality by race/ethnicity.MethodsThis was a retrospective analysis of nine 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. Students t-test, Fischer exact test, and multivariable regression analyses were performed.Results379 patients (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 have obesity, more frequently reported fever and myalgia, and had lower D-dimer levels compared to White patients (p&0.05). On multivariable analysis controlling for age, gender, obesity, cardiopulmonary comorbidities, hypertension, and diabetes, no significant differences in in-hospital mortality, ICU admission, or mechanical ventilation by race/ethnicity were found. Diabetes was a significant predictor for mechanical ventilation (OR 1.89; 95% CI 1.11-3.23) while older age was a predictor of in-hospital mortality (OR 4.18; 95% CI 1.94-9.04).ConclusionsIn this multi-center 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.© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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