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?:abstract
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Objectives Identification of racial differences in characteristics and comorbidities in patients hospitalized for COVID-19 and the impact on outcomes. Study design Retrospective observational study. Methods Data for all patients admitted to seven community hospitals in Michigan, United States with polymerase chain reaction confirmed diagnosis of COVID-19 from March 10 to April 15, 2020 was analyzed. The primary outcomes of racial disparity in inpatient mortality and intubation were analyzed using descriptive statistics and multivariate regression models. Results The study included 336 black and 408 white patients. Black patients were younger (62.9 +/- 15.0 years vs 71.8 +/- 16.4, P<.001), had a higher mean body mass index (32.4 +/- 8.6 vs 28.8 +/- 7.5, P<.001), had higher prevalence of diabetes (136/336 vs 130/408, P=.02) and presented later (6.6 +/-5.3 days after symptom onset vs. 5.4 +/- 5.4, P=.006) compared to white patients. Younger black patients had a higher prevalence of obesity (age< 65, 69.9%) than older black patients (age>65, 39.2%) and younger white patients (age<65, 55.1%). Intubation did not reach statistical significance for racial difference (black patients 61/335 vs. 54/406, P=.08). Mortality was not higher in black patients (65/335 vs. 142/406 in white patients, Odds ratio 0.61, 95% CI 0.37 to 0.99, 2 sided P=.05) in multivariate analysis, accounting for other risk factors associated with mortality. Conclusions Higher prevalence of obesity and diabetes in young black populations may be the critical factor driving disproportionate COVID-19 hospitalizations in black populations. Hospitalized black patients do not have worse outcomes compared to white patients.
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