Racial and Ethnic Differences and Clinical Outcomes of Patients With Coronavirus Disease 2019 (COVID-19) Presenting to the Emergency Department
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissionsoup.com..
BACKGROUND: Since the introduction of remdesivir and dexamethasone for severe COVID-19 treatment, few large multi-hospital-system US studies have described clinical characteristics and outcomes of minority COVID-19 patients who present to the emergency department (ED).
METHODS: This cohort study from the Cerner Real World Database (87 US health systems) from 1 December 2019 to 30 September 2020 included PCR-confirmed COVID-19 patients who self-identified as non-Hispanic Black (Black), Hispanic White (Hispanic), or non-Hispanic White (White). The main outcome was hospitalization among ED patients. Secondary outcomes included mechanical ventilation, intensive care unit care, and in-hospital mortality. Descriptive statistics and Poisson regression compared sociodemographics, comorbidities, receipt of remdesivir or dexamethasone, and outcomes by racial/ethnic groups and geographic region.
RESULTS: 94 683 COVID-19 patients presented to the ED. Blacks comprised 26.7% and Hispanics 33.6%. Nearly half (45.1%) of ED patients presented to hospitals in the South. 31.4% (n = 29 687) were hospitalized. Lower proportions of Blacks were prescribed dexamethasone (29.4%; n = 7426) compared with Hispanics (40.9%; n = 13 021) and Whites (37.5%; n = 14 088). Hospitalization risks, compared with Whites, were similar in Blacks (RR: .94; 95% CI: .82-1.08; P = .4) and Hispanics (.99; .81-1.21; P = .91), but risk of in-hospital mortality was higher in Blacks (1.18; 1.06-1.31; P = .002) and Hispanics (1.28; 1.13-1.44; P < .001).
CONCLUSIONS: Minority patients were overrepresented among COVID-19 ED patients, and while their risks of hospitalization were similar to Whites, in-hospital mortality risk was higher. Interventions targeting upstream social determinants of health are needed to reduce racial/ethnic disparities in COVID-19.
Errataetall: |
CommentIn: Clin Infect Dis. 2022 Feb 11;74(3):555-556. - PMID 34038517 |
---|---|
Medienart: |
E-Artikel |
Erscheinungsjahr: |
2022 |
---|---|
Erschienen: |
2022 |
Enthalten in: |
Zur Gesamtaufnahme - volume:74 |
---|---|
Enthalten in: |
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - 74(2022), 3 vom: 11. Feb., Seite 387-394 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Wiley, Zanthia [VerfasserIn] |
---|
Links: |
---|
Themen: |
COVID-19 |
---|
Anmerkungen: |
Date Completed 16.02.2022 Date Revised 07.12.2022 published: Print CommentIn: Clin Infect Dis. 2022 Feb 11;74(3):555-556. - PMID 34038517 Citation Status MEDLINE |
---|
doi: |
10.1093/cid/ciab290 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM323773796 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM323773796 | ||
003 | DE-627 | ||
005 | 20231225184912.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231225s2022 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1093/cid/ciab290 |2 doi | |
028 | 5 | 2 | |a pubmed24n1079.xml |
035 | |a (DE-627)NLM323773796 | ||
035 | |a (NLM)33822023 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Wiley, Zanthia |e verfasserin |4 aut | |
245 | 1 | 0 | |a Racial and Ethnic Differences and Clinical Outcomes of Patients With Coronavirus Disease 2019 (COVID-19) Presenting to the Emergency Department |
264 | 1 | |c 2022 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 16.02.2022 | ||
500 | |a Date Revised 07.12.2022 | ||
500 | |a published: Print | ||
500 | |a CommentIn: Clin Infect Dis. 2022 Feb 11;74(3):555-556. - PMID 34038517 | ||
500 | |a Citation Status MEDLINE | ||
520 | |a © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissionsoup.com. | ||
520 | |a BACKGROUND: Since the introduction of remdesivir and dexamethasone for severe COVID-19 treatment, few large multi-hospital-system US studies have described clinical characteristics and outcomes of minority COVID-19 patients who present to the emergency department (ED) | ||
520 | |a METHODS: This cohort study from the Cerner Real World Database (87 US health systems) from 1 December 2019 to 30 September 2020 included PCR-confirmed COVID-19 patients who self-identified as non-Hispanic Black (Black), Hispanic White (Hispanic), or non-Hispanic White (White). The main outcome was hospitalization among ED patients. Secondary outcomes included mechanical ventilation, intensive care unit care, and in-hospital mortality. Descriptive statistics and Poisson regression compared sociodemographics, comorbidities, receipt of remdesivir or dexamethasone, and outcomes by racial/ethnic groups and geographic region | ||
520 | |a RESULTS: 94 683 COVID-19 patients presented to the ED. Blacks comprised 26.7% and Hispanics 33.6%. Nearly half (45.1%) of ED patients presented to hospitals in the South. 31.4% (n = 29 687) were hospitalized. Lower proportions of Blacks were prescribed dexamethasone (29.4%; n = 7426) compared with Hispanics (40.9%; n = 13 021) and Whites (37.5%; n = 14 088). Hospitalization risks, compared with Whites, were similar in Blacks (RR: .94; 95% CI: .82-1.08; P = .4) and Hispanics (.99; .81-1.21; P = .91), but risk of in-hospital mortality was higher in Blacks (1.18; 1.06-1.31; P = .002) and Hispanics (1.28; 1.13-1.44; P < .001) | ||
520 | |a CONCLUSIONS: Minority patients were overrepresented among COVID-19 ED patients, and while their risks of hospitalization were similar to Whites, in-hospital mortality risk was higher. Interventions targeting upstream social determinants of health are needed to reduce racial/ethnic disparities in COVID-19 | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a COVID-19 | |
650 | 4 | |a disparities | |
650 | 4 | |a emergency department | |
650 | 4 | |a ethnicity | |
650 | 4 | |a race | |
700 | 1 | |a Ross-Driscoll, Katie |e verfasserin |4 aut | |
700 | 1 | |a Wang, Zhensheng |e verfasserin |4 aut | |
700 | 1 | |a Smothers, Laken |e verfasserin |4 aut | |
700 | 1 | |a Mehta, Aneesh K |e verfasserin |4 aut | |
700 | 1 | |a Patzer, Rachel E |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Clinical infectious diseases : an official publication of the Infectious Diseases Society of America |d 1992 |g 74(2022), 3 vom: 11. Feb., Seite 387-394 |w (DE-627)NLM012603007 |x 1537-6591 |7 nnns |
773 | 1 | 8 | |g volume:74 |g year:2022 |g number:3 |g day:11 |g month:02 |g pages:387-394 |
856 | 4 | 0 | |u http://dx.doi.org/10.1093/cid/ciab290 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 74 |j 2022 |e 3 |b 11 |c 02 |h 387-394 |