Racial and ethnic disparity in clinical outcomes among patients with confirmed COVID-19 infection in a large US electronic health record database
| Autor: | Brian K. Solow, Jerry G. Seare, Misti Paudel, Yvette M. Edmonds, Ami R Buikema, Paul Buzinec, Feng Cao, Stephanie Korrer, Sumit K. Jhamb, Harish Raja, Jonathan Johnson, Dibyajyoti Mazumder, Erin M. Hulbert, Katherine Andrade, Benjamin Chastek, U. Michael Currie |
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| Rok vydání: | 2021 |
| Předmět: |
Medicine (General)
Coronavirus disease 2019 (COVID-19) business.industry SARS-CoV-2 Ethnic group COVID-19 Retrospective cohort study Ethnic Groups General Medicine Odds ratio Logistic regression United States Race (biology) R5-920 Electronic health record Pandemic Medicine Electronic Health Records business Minority Groups Demography Research Paper Retrospective Studies |
| Zdroj: | EClinicalMedicine EClinicalMedicine, Vol 39, Iss, Pp 101075-(2021) |
| ISSN: | 2589-5370 |
| Popis: | Background Racial and ethnic minority groups have been disproportionately affected by the US coronavirus disease 2019 (COVID-19) pandemic; however, nationwide data on COVID-19 outcomes stratified by race/ethnicity and adjusted for clinical characteristics are sparse. This study analyzed the impacts of race/ethnicity on outcomes among US patients with COVID-19. Methods This was a retrospective observational study of patients with a confirmed COVID-19 diagnosis in the electronic health record from 01 February 2020 through 14 September 2020. Index encounter site, hospitalization, and mortality were assessed by race/ethnicity (Hispanic, non-Hispanic Black [Black], non-Hispanic White [White], non-Hispanic Asian [Asian], or Other/unknown). Associations between racial/ethnic categories and study outcomes adjusted for patient characteristics were evaluated using logistic regression. Findings Among 202,908 patients with confirmed COVID-19, patients from racial/ethnic minority groups were more likely than White patients to be hospitalized on initial presentation (Hispanic: adjusted odds ratio 1·690, 95% CI 1·620–1·763; Black: 1·810, 1·743–1·880; Asian: 1·503, 1·381–1·636) and during follow-up (Hispanic: 1·700, 1·638–1·764; Black: 1·578, 1·526–1·633; Asian: 1·391, 1·288–1·501). Among hospitalized patients, adjusted mortality risk was lower for Black patients (0·881, 0·809–0·959) but higher for Asian patients (1·205, 1·000–1·452). Interpretation Racial/ethnic minority patients with COVID-19 had more severe disease on initial presentation than White patients. Increased mortality risk was attenuated by hospitalization among Black patients but not Asian patients, indicating that outcome disparities may be mediated by distinct factors for different groups. In addition to enacting policies to facilitate equitable access to COVID-19–related care, further analyses of disaggregated population-level COVID-19 data are needed. Funding None. |
| Databáze: | OpenAIRE |
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