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- Title
How Do Presenting Symptoms and Outcomes Differ by Race/Ethnicity Among Hospitalized Patients With Coronavirus Disease 2019 Infection? Experience in Massachusetts.
- Authors
McCarty, Thomas R; Hathorn, Kelly E; Redd, Walker D; Rodriguez, Nicolette J; Zhou, Joyce C; Bazarbashi, Ahmad Najdat; Njie, Cheikh; Wong, Danny; Trinh, Quoc-Dien; Shen, Lin; Stone, Valerie E; Chan, Walter W
- Abstract
Background Population-based literature suggests severe acute respiratory syndrome coronavirus 2 infection may disproportionately affect racial/ethnic minorities; however, patient-level observations of hospitalization outcomes by race/ethnicity are limited. Our aim in this study was to characterize coronavirus disease 2019 (COVID-19)–associated morbidity and in-hospital mortality by race/ethnicity. Methods This was a retrospective analysis of 9 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. Student t test, Fischer exact test, and multivariable regression analyses were performed. Results A total of 379 patients (aged 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 be obese, more frequently reported fever and myalgia, and had lower D-dimer levels compared with white patients (P <.05). On multivariable analysis controlling for age, gender, obesity, cardiopulmonary comorbidities, hypertension, and diabetes, no significant differences in in-hospital mortality, intensive care unit admission, or mechanical ventilation by race/ethnicity were found. Diabetes was a significant predictor for mechanical ventilation (odds ratio [OR], 1.89; 95% confidence interval [CI], 1.11–3.23), while older age was a predictor of in-hospital mortality (OR, 4.18; 95% CI, 1.94–9.04). Conclusions In this multicenter 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.
- Subjects
COVID-19; HEALTH services accessibility; CONFIDENCE intervals; MULTIPLE regression analysis; MULTIVARIATE analysis; RACE; HEALTH status indicators; DISEASES; RETROSPECTIVE studies; HEALTH outcome assessment; FISHER exact test; HOSPITAL mortality; T-test (Statistics); COMPARATIVE studies; ETHNIC groups; ODDS ratio; FIBRIN fibrinogen degradation products
- Publication
Clinical Infectious Diseases, 2021, Vol 73, Issue 11, pe4131
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciaa1245