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

Abstract

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, LA with reactive SARS-CoV-2 testing from March 9-31, 2020. Clinical characteristics of Black and other racial/ethnic group patients were compared using Wilcoxon rank-sum test and Fisher’s exact tests. The relationship between race and outcome was assessed using Day-14 status on an ordinal scale. Results This study included 249 patients. Median age was 59, 44% were male, 86% were age ≥65y or had ≥1comorbidity. Overall, 87% were Black, relative to 55% Black patients typically hospitalized at our center. Black patients had longer symptom duration at presentation (6.41 versus 5.88 days, p=0.05), and were more likely to have asthma (p=0.008), but less likely to have dementia (p=0.002). There were no racial differences in initial respiratory status or laboratory values except higher LDH 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. Conclusion 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 towards reducing COVID-19 related racial inequities.

Dementia and COVID-19 among Older African American Adults: A Scoping Review of Healthcare Access and Resources

“…Although the authors did not specifically analyze Levesque’s framework, they nevertheless utilized terms similar or identical to those in the framework. Half of the studies reported the availability (or lack) of healthcare resources due to financial insecurities, a lack of healthcare insurance, education/knowledge gaps, transportation, Internet/phone or telemedicine, cognitive screening, ambulatory care, and so on ([ 26 , 36 , 37 , 38 , 39 ]) (See Table 4 ). These were grouped as materials, financial insecurities, and knowledge gaps.…”

“…These were grouped as materials, financial insecurities, and knowledge gaps. Four studies (50%) focused on a combination of accessibility and resourcing associated with insurance and Internet/telemedicine utilization ([ 36 , 37 , 38 , 39 ]). We discuss each of the emerging themes and subthemes below (See Table 3 and Table 4 ).…”

“…One study focused on dementia and altered mental status among older African American adults with dementia, noting the presence of comorbidities such as kidney and cerebrovascular disease [ 26 ]. One study noted the absolute lack of insurance of participants [ 38 ] In addition, two studies reported that participants had Medicaid [ 39 ] and Medicare [ 36 ], although they had issues with accessing associated benefits. Participants in the remaining six studies used private insurance.…”

Asthma in patients with coronavirus disease 2019

“…Subsequently, 44 articles were excluded because of a sample size less than 100, 47 articles were eliminated due to the potential duplicate patients, and two articles were removed because they reported unclear prevalence of asthma in COVID-19 patients (eTable 2). Ultimately, 116 articles (119 studies) 4 , 6 , 7 , 8 , 9 , 10 , 11 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ,…”

Coronavirus Vaccine Distribution: Moving to a Race Conscious Approach for a Racially Disparate Problem

“…In Michigan, for example, Blacks make up 14% of the population but 40% of COVID-related deaths [6]. In New Orleans, while making up less than one-third of the general population, Blacks "account for almost 60 percent of the COVID-related deaths" [7].…”