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?:abstract
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Study Objectives: The effects of COVID-19 on racial groups is still emerging, however a recent report from the Centers for Disease Control and Prevention (CDC) suggests that there may be a disproportionate rate of severity of disease presentation in racial and ethnic minority groups Health differences have been attributed to economic and social conditions that are more prevalent for racial minorities These conditions can cause isolation from resources necessary to combat the outbreak We suspect that these factors that may contribute to increased Covid-19 exposures, that lead to a greater rate of infection and increased risk of severe disease in minority groups Methods: Data collected from three ED, all sites of an emergency medicine residency Included are patients with SAR-CoV-2 testing done in the ED Excluded were patients less than 18, pregnancy, and missing data Race was categorized into White-Caucasian (W), African-American (B), Latinx (L), and others including multi-racial (O) COVID co-morbidities were defined as hypertension, diabetes, chronic obstructive pulmonary disease or asthma, sleep apnea, congestive heart failure, coronary artery disease, end-stage renal disease, diabetic kidney disease, liver disease, venous thrombosis, cancer, HIV, and immune-compromised 5% of patients’ select variables were manually re-abstracted with a Kappa of 100% Significance (alpha=0 05) was tested using Student-t, ANOVA, and Chi-squared as appropriate Logistic regression was used to determine the independent effect of race on outcomes Results: 5489 cases met inclusion/exclusion criteria SAR-CoV-2 was detected in 1849 (33 7%) Tested racial diversity was 37 9% W, 20 0% B, 33 5% L, and 8 6% O There was significant racial disparity in the positivity rate (W: 25 0%, B: 31 9%, L: 43 8%, O: 36 7%;p< 001) Hospitalized were 1112 (60 1%) positive patients with mean age of 67 7, 42 4% female, acuity 2 49 (1-5, 1 worst), and racial diversity W: 36 8%, B: 19 3%, L: 35 9%, O: 8 0% As of 6-5-2020, there were 265 deaths (23 8%) and 180 placed on ventilators (16 2%) with a combined mortality morbidity (MM) of 359 (32 3%) Age (p<0 001), acuity (p<0 001), co-morbidities (p=0 003), and race (p<0 001) were all significantly associated with mortality On logistic regression, age (OR=1 049;p<0 001), sex (OR=0 647;p=0 008), and acuity (OR=0 434;P<0 001) were significant predictors of mortality There were significant mortality differences among races (B v W, OR=0 566;p=0 021, L v W, OR=1 050;p=0 817, O v W, OR=0 866;p=0 630) Significant racial differences were also found for ventilator need (B v W, OR=0 792;p=0 433, L v W, OR=2 24;p=0 001, O v W, OR=1 71;p=0 110) Co-morbidities were not significant when controlled for age and other confounders Conclusion: Our findings showed minority groups were more likely to have a positive COVID-19 test Latinx patients were more than twice as likely to require intubation compared to white patients Age, Sex, Triage Acuity Level, and non-White Race were significantly associated with mortality This data suggests non-White patients are more likely to contract and suffer from Covid-19 These findings show minority groups have a greater need for ventilators and other resources associated with severe Covid-19 In the event of resource shortages, they should be directed to minority communities [Formula presented]
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