Imaging Utilization and Outcomes in Vulnerable Populations during COVID-19 in New York City
2020 by the Radiological Society of North America, Inc..
BACKGROUND: Coronavirus disease 2019 (COVID-19) affects vulnerable populations (VP) adversely.
PURPOSE: To evaluate overall imaging utilization in vulnerable subgroups (elderly, racial/ethnic minorities, socioeconomic status [SES] disadvantage) and determine if a particular subgroup has worse outcomes from COVID-19.
MATERIALS/METHODS: Of 4110 patients who underwent COVID-19 testing from March 3-April 4, 2020 at NewYork-Presbyterian Hospital (NYP) health system, we included 1121 COVID-19 positive adults (mean age 59±18 years, 59% male) from two academic hospitals and evaluated imaging utilization rates and outcomes, including mortality.
RESULTS: Of 897 (80%) VP, there were 465 (41%) elderly, 380 (34%) racial/ethnic minorities, and 479 (43%) SES disadvantage patients. Imaging was performed in 88% of patients and mostly portable/bedside studies, with 87% of patients receiving chest radiographs. There were 83% hospital admissions, 25% ICU admissions, 23% intubations, and 13% deaths. Elderly patients had greater imaging utilization, hospitalizations, ICU/intubation requirement, longer hospital stays, and >4-fold increase in mortality compared to non-elderlies (adjusted hazard ratio[aHR] 4.79, p<0.001). Self-reported minorities had fewer ICU admissions (p=0.03) and reduced hazard for mortality (aHR 0.53, p=0.004; complete case analysis: aHR 0.39, p<0.001 excluding "not reported"; sensitivity analysis: aHR 0.61, p=0.005 "not reported" classified as minorities) with similar imaging utilization, compared to non-minorities. SES disadvantage patients had similar imaging utilization and outcomes as compared to their counterparts.
CONCLUSIONS: In a predominantly hospitalized New York City cohort, elderly patients are at highest mortality risk. Racial/ethnic minorities and SES disadvantage patients fare better or similarly to their counterparts, highlighting the critical role of access to inpatient medical care during the COVID-19 pandemic.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:2 |
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| Enthalten in: |
Radiology. Cardiothoracic imaging - 2(2020), 6 vom: 24. Dez., Seite e200464 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Toy, Dennis [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Revised 21.04.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1148/ryct.2020200464 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM323344933 |
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| 245 | 1 | 0 | |a Imaging Utilization and Outcomes in Vulnerable Populations during COVID-19 in New York City |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Revised 21.04.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a 2020 by the Radiological Society of North America, Inc. | ||
| 520 | |a BACKGROUND: Coronavirus disease 2019 (COVID-19) affects vulnerable populations (VP) adversely | ||
| 520 | |a PURPOSE: To evaluate overall imaging utilization in vulnerable subgroups (elderly, racial/ethnic minorities, socioeconomic status [SES] disadvantage) and determine if a particular subgroup has worse outcomes from COVID-19 | ||
| 520 | |a MATERIALS/METHODS: Of 4110 patients who underwent COVID-19 testing from March 3-April 4, 2020 at NewYork-Presbyterian Hospital (NYP) health system, we included 1121 COVID-19 positive adults (mean age 59±18 years, 59% male) from two academic hospitals and evaluated imaging utilization rates and outcomes, including mortality | ||
| 520 | |a RESULTS: Of 897 (80%) VP, there were 465 (41%) elderly, 380 (34%) racial/ethnic minorities, and 479 (43%) SES disadvantage patients. Imaging was performed in 88% of patients and mostly portable/bedside studies, with 87% of patients receiving chest radiographs. There were 83% hospital admissions, 25% ICU admissions, 23% intubations, and 13% deaths. Elderly patients had greater imaging utilization, hospitalizations, ICU/intubation requirement, longer hospital stays, and >4-fold increase in mortality compared to non-elderlies (adjusted hazard ratio[aHR] 4.79, p<0.001). Self-reported minorities had fewer ICU admissions (p=0.03) and reduced hazard for mortality (aHR 0.53, p=0.004; complete case analysis: aHR 0.39, p<0.001 excluding "not reported"; sensitivity analysis: aHR 0.61, p=0.005 "not reported" classified as minorities) with similar imaging utilization, compared to non-minorities. SES disadvantage patients had similar imaging utilization and outcomes as compared to their counterparts | ||
| 520 | |a CONCLUSIONS: In a predominantly hospitalized New York City cohort, elderly patients are at highest mortality risk. Racial/ethnic minorities and SES disadvantage patients fare better or similarly to their counterparts, highlighting the critical role of access to inpatient medical care during the COVID-19 pandemic | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Diagnostic Imaging | |
| 650 | 4 | |a Healthcare Disparities | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Radiology | |
| 650 | 4 | |a SARS Virus | |
| 650 | 4 | |a severe acute respiratory syndrome coronavirus 2 | |
| 700 | 1 | |a Mahmood, Syed S |e verfasserin |4 aut | |
| 700 | 1 | |a Rotman, Jessica |e verfasserin |4 aut | |
| 700 | 1 | |a Weisman, Stacey Verzosa |e verfasserin |4 aut | |
| 700 | 1 | |a Escalon, Joanna G |e verfasserin |4 aut | |
| 700 | 1 | |a Legasto, Alan C |e verfasserin |4 aut | |
| 700 | 1 | |a Cheng, Edward P |e verfasserin |4 aut | |
| 700 | 1 | |a McKenney, Anna Sophia |e verfasserin |4 aut | |
| 700 | 1 | |a Barbar, Tarek |e verfasserin |4 aut | |
| 700 | 1 | |a Balkan, Lauren |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Yunchan |e verfasserin |4 aut | |
| 700 | 1 | |a Razavi, Peyman |e verfasserin |4 aut | |
| 700 | 1 | |a Zainul, Omar |e verfasserin |4 aut | |
| 700 | 1 | |a Abedian, Sajjad |e verfasserin |4 aut | |
| 700 | 1 | |a Gruden, James F |e verfasserin |4 aut | |
| 700 | 1 | |a Truong, Quynh A |e verfasserin |4 aut | |
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