The Magnitude of Black/Hispanic Disparity in COVID-19 Mortality Across United States Counties During the First Waves of the COVID-19 Pandemic

Im, Cindy; Munasinghe, Lalani L.; Martı́nez, José Miguel; Letsou, William; Bagherzadeh‐Khiabani, Farideh; Marin, Soudabeh; Yasui, Yutaka

doi:10.3389/ijph.2021.1604004

Cited by 3 publications

(3 citation statements)

References 14 publications

(24 reference statements)

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“…The current findings add to data demonstrating how the pandemic has impacted marginalized and minoritized populations 49–54. Homelessness was associated with mortality at the end, but not the start, of follow-up.…”

Section: Discussionsupporting

confidence: 60%

“…[48] The current findings add to data demonstrating how the pandemic has impacted marginalized and minoritized populations. [49][50][51][52][53][54] Homelessness was associated with mortality at the end, but not the start, of follow-up. While the pandemic has hampered the efforts to collect data about homelessness and homeless populations, [55,56] this finding indicates that patients with cirrhosis and unstable housing or homelessness may require special outreach efforts.…”

Section: Discussionmentioning

confidence: 98%

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The road to pandemic recovery: Tracking COVID-19’s impact on cirrhosis care and outcomes among 111,558 Veterans

et al. 2023

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Background & Aims: This study aimed to evaluate quarterly trends in process and health outcomes among Veterans with cirrhosis and assess the factors associated with cirrhosis outcomes before and during the COVID-19 pandemic. Approach & Results: US Veterans with cirrhosis were identified using the Veterans Health Administration Corporate Data Warehouse. Quarterly measures were evaluated from September 30, 2018, through March 31, 2022, including twice yearly screening for hepatocellular carcinoma (HCC-6), new HCC, surveillance for or treatment of esophageal varices, variceal bleeding, all-cause hospitalization, and mortality. Joinpoint analyses were used to assess the changes in trends over time. Logistic regression models were used to identify the demographic and medical factors associated with each outcome over time. Among 111,558 Veterans with cirrhosis with a mean Model for End-stage Liver Disease-Sodium of 11±5, rates of HCC-6 sharply declined from a prepandemic peak of 41%, to a nadir of 28%, and rebounded to 36% by March 2022. All-cause mortality did not significantly change over the pandemic, but new HCC diagnosis, EVST, variceal bleeding, and all-cause hospitalization significantly declined over follow-up. Quarterly HCC diagnosis declined from 0.49% to 0.38%, EVST from 50% to 41%, variceal bleeding from 0.15% to 0.11%, and hospitalization from 9% to 5%. Rurality became newly, significantly associated with nonscreening over the pandemic (aOR for HCC−6=0.80, 95% CI 0.74 to 0.86; aOR for EVST=0.95, 95% CI 0.90 to 0.997). Conclusions: The pandemic continues to impact cirrhosis care. Identifying populations at the highest risk of care disruptions may help to address ongoing areas of need.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 98%

The road to pandemic recovery: Tracking COVID-19’s impact on cirrhosis care and outcomes among 111,558 Veterans

et al. 2023

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“…Most previous studies have used SARS-CoV-2 testing databases [26], or hospitalization record [26] which do not lend themselves to assess the prevalence of chronic conditions in the underlying cohorts. Studies of databases as Medicare are limited by the exclusion of referent population (i.e., persons under 65 years of age [28], or ignored the assessment of interaction altogether [29][30][31][32][33][34][35][36][37].…”

Section: Source: City Of El Paso Department Of Public Healthmentioning

confidence: 99%

Observations on the interaction of older age and diabetes on COVID-19 mortality, and of non-pharmaceutical interventions on daily reported cases in El Paso, Texas, 2020

Cárdenas¹,

Cardenas

Ocaranza

et al. 2023

AJFE

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Introduction. In El Paso, Texas, a largely Hispanic population, a large surge of COVID-19 occurred in October 2020. Using public health surveillance data and a field survey we report on the epidemiology and control of this pandemic in 2020. Population and methods. We used reported COVID-19 cases to the notifiable disease reporting system to: 1) calculate morbidity and mortality rate ratios by age, gender, race/ethnicity, and poverty; and 2) to assess temporal trends using joinpoint regression. A door-to-door cluster sampling serologic survey assessed prevalence of SARS-CoV-2 infection. We calculated the relative excess risk due to interaction (RERI) of older age and diabetes on mortality from COVID-19. Results. By the end of 2020, the reported morbidity and mortality were 0.8% and 216.8 per 100,000 population, respectively. The overall prevalence of infection reached 18.5%. Compared to those under 20 years of age, the reported morbidity was nearly twice among 65+ years of age (RR=1.6 [95% CI=1.6, 1.7]), but the mortality in this group was disproportionately large (RR=1,026 [95% CI=329.0, 3,171.0]). Hispanics had twice the morbidity and mortality than non-Hispanics. Essential workers had an increased prevalence of SARS-CoV-2 infection compared to other occupations. Social distancing measures appeared to have contributed to decrease the morbidity by the end of 2020. Diabetes and older age jointly increased the risk of COVID-19 mortality (RERI=27.9 [95% CI = 24.0, 32.2]). Conclusions. US Hispanics experienced excess COVID-19 morbidity and mortality. Older age and diabetes mellitus synergistically increased the risk of COVID-19 mortality.

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A comparison of severity of illness between the SARS-CoV-2 Omicron variant and Delta variant

Ellis,

Hess,

Huynh

et al. 2023

ASHE

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Background: The COVID-19 pandemic has disproportionally affected traditionally marginalized groups. Both the Delta and Omicron variants raised concern amongst public health officials due to potentially higher infectivity rates and disease severity than prior variants. This study sought to compare disease severity between adults infected with the Omicron variant and adults infected with the Delta variant who presented to the Emergency Department at an academic, safety-net hospital in Virginia. Methods: This retrospective cohort study used electronic medical record data of patients who presented to the Emergency Department and received a positive SARS-CoV-2 test between September 1, 2021, and January 31, 2022. Positive tests were stratified by genotypic variant through whole genome sequencing. Participants with the Omicron variant were propensity scores matched with individuals with the Delta variant. Results: Among 500 Delta and 500 Omicron participants, 279 propensity score-matched pairs were identified. Participants were predominantly unvaccinated, with medical comorbidities, and self-identified as Black. Individuals infected with the Delta variant had more severe disease compared to those with the Omicron variant, regardless of vaccination status. Patients with kidney, liver, and respiratory disease, as well as cancer, are at higher risk for severe disease. Patients with 2 doses of COVID-19 immunization trended toward less severe disease. Conclusions: Overall, these data further support the literature regarding the disproportionate effects of the COVID-19 pandemic on vulnerable patient populations – such as those with limited access to care, people of color, and those with chronic medical conditions – and can be used to inform public health interventions.

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The Magnitude of Black/Hispanic Disparity in COVID-19 Mortality Across United States Counties During the First Waves of the COVID-19 Pandemic

Cited by 3 publications

References 14 publications

The road to pandemic recovery: Tracking COVID-19’s impact on cirrhosis care and outcomes among 111,558 Veterans

The road to pandemic recovery: Tracking COVID-19’s impact on cirrhosis care and outcomes among 111,558 Veterans

Observations on the interaction of older age and diabetes on COVID-19 mortality, and of non-pharmaceutical interventions on daily reported cases in El Paso, Texas, 2020

A comparison of severity of illness between the SARS-CoV-2 Omicron variant and Delta variant

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