INTRODUCTION: At the population level, Black and Hispanic adults in the United States have increased risk of dying from COVID-19, yet whether race and ethnicity impact on risk of mortality among those hospitalized for COVID-19 is unclear. METHODS: Retrospective cohort study using data on adults hospitalized with COVID-19 from the electronic health record from 52 health systems across the United States contributing data to Cerner Real World DataTM. In-hospital mortality was evaluated by race first in unadjusted analysis then sequentially adjusting for demographics and clinical characteristics using logistic regression. RESULTS: Through August 2020, 19,584 patients with median age 52 years were hospitalized with COVID-19, including n = 4,215 (21.5%) Black and n = 5,761 (29.4%) Hispanic patients. Relative to white patients, crude mortality was slightly higher in Black adults [22.7% vs 20.8%, unadjusted OR 1.12 (95% CI 1.02-1.22)]. Mortality remained higher among Black adults after adjusting for demographic factors including age, sex, date, region, and insurance status (OR 1.13, 95% CI 1.01-1.27), but not after including comorbidities and body mass index (OR 1.07, 95% CI 0.93-1.23). Compared with non-Hispanic patients, Hispanic patients had lower mortality both in unadjusted and adjusted models [mortality 12.7 vs 25.0%, unadjusted OR 0.44(95% CI 0.40-0.48), fully adjusted OR 0.71 (95% CI 0.59-0.86)]. DISCUSSION: In this large, multicenter, EHR-based analysis, Black adults hospitalized with COVID-19 had higher observed mortality than white patients due to a higher burden of comorbidities in Black adults. In contrast, Hispanic ethnicity was associated with lower mortality, even in fully adjusted models.
INTRODUCTION: At the population level, Black and Hispanic adults in the United States have increased risk of dying from COVID-19, yet whether race and ethnicity impact on risk of mortality among those hospitalized for COVID-19 is unclear. METHODS: Retrospective cohort study using data on adults hospitalized with COVID-19 from the electronic health record from 52 health systems across the United States contributing data to Cerner Real World DataTM. In-hospital mortality was evaluated by race first in unadjusted analysis then sequentially adjusting for demographics and clinical characteristics using logistic regression. RESULTS: Through August 2020, 19,584 patients with median age 52 years were hospitalized with COVID-19, including n = 4,215 (21.5%) Black and n = 5,761 (29.4%) Hispanic patients. Relative to white patients, crude mortality was slightly higher in Black adults [22.7% vs 20.8%, unadjusted OR 1.12 (95% CI 1.02-1.22)]. Mortality remained higher among Black adults after adjusting for demographic factors including age, sex, date, region, and insurance status (OR 1.13, 95% CI 1.01-1.27), but not after including comorbidities and body mass index (OR 1.07, 95% CI 0.93-1.23). Compared with non-Hispanic patients, Hispanic patients had lower mortality both in unadjusted and adjusted models [mortality 12.7 vs 25.0%, unadjusted OR 0.44(95% CI 0.40-0.48), fully adjusted OR 0.71 (95% CI 0.59-0.86)]. DISCUSSION: In this large, multicenter, EHR-based analysis, Black adults hospitalized with COVID-19 had higher observed mortality than white patients due to a higher burden of comorbidities in Black adults. In contrast, Hispanic ethnicity was associated with lower mortality, even in fully adjusted models.
Authors: Tori L Cowger; Brigette A Davis; Onisha S Etkins; Keletso Makofane; Jourdyn A Lawrence; Mary T Bassett; Nancy Krieger Journal: JAMA Netw Open Date: 2020-07-01
Authors: Gbenga Ogedegbe; Joseph Ravenell; Samrachana Adhikari; Mark Butler; Tiffany Cook; Fritz Francois; Eduardo Iturrate; Girardin Jean-Louis; Simon A Jones; Deborah Onakomaiya; Christopher M Petrilli; Claudia Pulgarin; Seann Regan; Harmony Reynolds; Azizi Seixas; Frank Michael Volpicelli; Leora Idit Horwitz Journal: JAMA Netw Open Date: 2020-12-01
Authors: David A Asch; Natalie E Sheils; Md Nazmul Islam; Yong Chen; Rachel M Werner; John Buresh; Jalpa A Doshi Journal: JAMA Intern Med Date: 2021-04-01 Impact factor: 21.873
Authors: Fatima Rodriguez; Nicole Solomon; James A de Lemos; Sandeep R Das; David A Morrow; Steven M Bradley; Mitchell S V Elkind; Joseph H Williams; DaJuanicia Holmes; Roland A Matsouaka; Divya Gupta; Ty J Gluckman; Marwah Abdalla; Michelle A Albert; Clyde W Yancy; Tracy Y Wang Journal: Circulation Date: 2020-11-17 Impact factor: 29.690
Authors: Rafi Kabarriti; N Patrik Brodin; Maxim I Maron; Chandan Guha; Shalom Kalnicki; Madhur K Garg; Andrew D Racine Journal: JAMA Netw Open Date: 2020-09-01
Authors: Cary P Gross; Utibe R Essien; Saamir Pasha; Jacob R Gross; Shi-Yi Wang; Marcella Nunez-Smith Journal: J Gen Intern Med Date: 2020-08-04 Impact factor: 5.128
Authors: Zichen Wang; Amanda Zheutlin; Yu-Han Kao; Kristin Ayers; Susan Gross; Patricia Kovatch; Sharon Nirenberg; Alexander Charney; Girish Nadkarni; Jessica K De Freitas; Paul O'Reilly; Allan Just; Carol Horowitz; Glenn Martin; Andrea Branch; Benjamin S Glicksberg; Dennis Charney; David Reich; William K Oh; Eric Schadt; Rong Chen; Li Li Journal: BMJ Open Date: 2020-10-26 Impact factor: 2.692
Authors: Tian Gu; Jasmine A Mack; Maxwell Salvatore; Swaraaj Prabhu Sankar; Thomas S Valley; Karandeep Singh; Brahmajee K Nallamothu; Sachin Kheterpal; Lynda Lisabeth; Lars G Fritsche; Bhramar Mukherjee Journal: JAMA Netw Open Date: 2020-10-01
Authors: Ngo Fung Daniel Lam; Hongfei Sun; Liming Song; Dongrong Yang; Shaohua Zhi; Ge Ren; Pak Hei Chou; Shiu Bun Nelson Wan; Man Fung Esther Wong; King Kwong Chan; Hoi Ching Hailey Tsang; Feng-Ming Spring Kong; Yì Xiáng J Wáng; Jing Qin; Lawrence Wing Chi Chan; Michael Ying; Jing Cai Journal: Quant Imaging Med Surg Date: 2022-07
Authors: Madeleine R Heldman; Olivia S Kates; Kassem Safa; Camille N Kotton; Sarah J Georgia; Julie M Steinbrink; Barbara D Alexander; Marion Hemmersbach-Miller; Emily A Blumberg; Ashrit Multani; Brandy Haydel; Ricardo M La Hoz; Lisset Moni; Yesabeli Condor; Sandra Flores; Carlos G Munoz; Juan Guitierrez; Esther I Diaz; Daniela Diaz; Rodrigo Vianna; Giselle Guerra; Matthias Loebe; Robert M Rakita; Maricar Malinis; Marwan M Azar; Vagish Hemmige; Margaret E McCort; Zohra S Chaudhry; Pooja P Singh; Kailey Hughes Kramer; Arzu Velioglu; Julie M Yabu; Jose A Morillis; Sapna A Mehta; Sajal D Tanna; Michael G Ison; Ariella C Derenge; David van Duin; Adrienne Maximin; Carlene Gilbert; Jason D Goldman; Erika D Lease; Cynthia E Fisher; Ajit P Limaye Journal: Am J Transplant Date: 2021-10-07 Impact factor: 9.369
Authors: Kapil Khadka; Kunle Adesigbin; Jessica Beetch; Katrin Kuhn; Aaron Wendelboe Journal: Int J Environ Res Public Health Date: 2022-07-14 Impact factor: 4.614