Background and Aims Initial reports on US COVID-19 showed different outcomes in different races. In this study we use a diverse large cohort of hospitalized COVID-19 patients to determine predictors of mortality. Methods We analyzed data from hospitalized COVID-19 patients (n = 5852) between March 2020- August 2020 from 8 hospitals across the US. Demographics, comorbidities, symptoms and laboratory data were collected. Results The cohort contained 3,662 (61.7%) African Americans (AA), 286 (5%) American Latinx (LAT), 1,407 (23.9%), European Americans (EA), and 93 (1.5%) American Asians (AS). Survivors and non-survivors mean ages in years were 58 and 68 for AA, 58 and 77 for EA, 44 and 61 for LAT, and 51 and 63 for AS. Mortality rates for AA, LAT, EA and AS were 14.8, 7.3, 16.3 and 2.2%. Mortality increased among patients with the following characteristics: age, male gender, New York region, cardiac disease, COPD, diabetes mellitus, hypertension, history of cancer, immunosuppression, elevated lymphocytes, CRP, ferritin, D-Dimer, creatinine, troponin, and procalcitonin. Use of mechanical ventilation (p = 0.001), shortness of breath (SOB) (p < 0.01), fatigue (p = 0.04), diarrhea (p = 0.02), and increased AST (p < 0.01), significantly correlated with death in multivariate analysis. Male sex and EA and AA race/ethnicity had higher frequency of death. Diarrhea was among the most common GI symptom amongst AAs (6.8%). When adjusting for comorbidities, significant variables among the demographics of study population were age (over 45 years old), male sex, EA, and patients hospitalized in New York. When adjusting for disease severity, significant variables were age over 65 years old, male sex, EA as well as having SOB, elevated CRP and D-dimer. Glucocorticoid usage was associated with an increased risk of COVID-19 death in our cohort. Conclusion Among this large cohort of hospitalized COVID-19 patients enriched for African Americans, our study findings may reflect the extent of systemic organ involvement by SARS-CoV-2 and subsequent progression to multi-system organ failure. High mortality in AA in comparison with LAT is likely related to high frequency of comorbidities and older age among AA. Glucocorticoids should be used carefully considering the poor outcomes associated with it. Special focus in treating patients with elevated liver enzymes and other inflammatory biomarkers such as CRP, troponin, ferritin, procalcitonin, and D-dimer are required to prevent poor outcomes.

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Since COVID-19 occurrence in late 2019, intense research efforts on an unprecedented scale have focused on the study of SARS CoV-2 entry mechanisms and clinical presentations. As for other coronaviruses, SARS-CoV-2 presents with extra-respiratory clinical manifestations like diarrhea, nausea, vomiting and abdominal pain which highlight that the gastrointestinal (GI) system as another viral target along with the typical presentations of COVID-19 which is characterized primarily by respiratory symptoms. The digestive system is involved in many systemic functions through the gut-brain-axis and systemic immunity modulation. Therefore, the GI system plays an important role in the presentation of the disease, pathogenesis, and possibly treatment outcome. This mini-review summarizes recent work to study SARS-CoV-2 infection as it relates to comorbidities, GI symptoms. This will help to strategize the priorities in understanding the impact of the virus on outcome in various aspects.

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S evere acute respiratory syndrome coronavirus 2 caused a worldwide outbreak. Its associated disease, coronaviruses disease 2019 (COVID-19), causes respiratory, gastrointestinal (GI), inflammatory, and neurologic symptoms. 1 In the United States, minorities such as African Americans (AA) and Hispanics (HSP) have shown a higher incidence of the disease. 2,3 . However, no detailed characterization of the disease's features in these populations has been performed. 4 Although the initial focus was on saving lives and developing and delivering vaccines and therapeutics, the focus is shifting toward an assessment of specific features of the disease in different patient groups, variables that affect outcome, and, more importantly, factors that correlate with persistent and recurring symptoms. 5 In this study we describe the demographics, clinical features, and GI symptoms of hospitalized minority patients with confirmed severe acute respiratory syndrome coronavirus 2 infection at a tertiary hospital located in Washington, DC. We also sought to determine how these features relate to outcomes and which can be considered for prognosis assessment. Methods Patient SelectionA list of 447 hospitalized adult (March to September 2020 at Howard University Hospital) COVID-19 patients was obtained. This study was approved by the Institutional Review Board. Demographics, clinical values, comorbidities, laboratory test results, and treatment data were collected from patient charts.