Silver Victoria, Chapple Andrew G, Feibus Allison H, Beckford Jeremy, Halapin Natalie A, Barua Delphi, Gordon Angellica, Baumgartner Will, Vignes Seth, Clark Cullen, Kamboj Sanjay, Lim Stephen C, Mackey Scott P, Seal Paula S, Kanter Joseph M, Bell Caryn, Clement Meredith E
Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.
Biostatistics Program, LSUHSC School of Public Health, New Orleans, Louisiana, USA.
Open Forum Infect Dis. 2020 Aug 13;7(9):ofaa339. doi: 10.1093/ofid/ofaa339. eCollection 2020 Sep.
In Louisiana, deaths related to COVID-19 have disproportionately occurred in Black persons. Granular data are needed to better understand inequities and develop prevention strategies to mitigate further impact on Black communities.
We conducted a retrospective study of patients admitted to an urban safety net hospital in New Orleans, Louisiana, with reactive SARS-CoV-2 testing from March 9 to 31, 2020. Clinical characteristics of Black and other racial/ethnic group patients were compared using Wilcoxon rank-sum test and Fisher exact tests. The relationship between race and outcome was assessed using day 14 status on an ordinal scale.
This study included 249 patients. The median age was 59, 44% were male, and 86% were age ≥65 years or had ≥1 comorbidity. Overall, 87% were Black, relative to 55% Black patients typically hospitalized at our center. Black patients had longer symptom duration at presentation (6.41 vs 5.88 days; = .05) and were more likely to have asthma ( = .008) but less likely to have dementia ( = .002). There were no racial differences in initial respiratory status or laboratory values except for higher lactate dehydrogenase in Black patients. Patient age and initial oxygen requirement, but not race (adjusted proportional odds ratio, 0.92; 95% CI, 0.70-1.20), were associated with worse day 14 outcomes.
Our results demonstrate minor racial differences in comorbidities or disease severity at presentation, and day 14 outcomes were not different between groups. However, Black patients were disproportionately represented in hospitalizations, suggesting that prevention efforts should include strategies to limit SARS-CoV-2 exposures and transmission in Black communities as one step toward reducing COVID-19-related racial inequities.
在路易斯安那州,与新型冠状病毒肺炎(COVID-19)相关的死亡病例在黑人中所占比例过高。需要详细数据以更好地了解不平等现象,并制定预防策略以减轻对黑人社区的进一步影响。
我们对2020年3月9日至31日在路易斯安那州新奥尔良市一家城市安全网医院收治的、接受过反应性严重急性呼吸综合征冠状病毒2(SARS-CoV-2)检测的患者进行了一项回顾性研究。使用Wilcoxon秩和检验和Fisher精确检验比较黑人和其他种族/族裔患者的临床特征。使用第14天的序数量表评估种族与结局之间的关系。
本研究纳入了249例患者。中位年龄为59岁,44%为男性,86%年龄≥65岁或患有≥1种合并症。总体而言,87%为黑人,而在我们中心住院的患者中黑人患者通常占55%。黑人患者就诊时症状持续时间更长(6.41天对5.88天;P = 0.05),更有可能患有哮喘(P = 0.008),但患痴呆症的可能性较小(P = 0.002)。除黑人患者乳酸脱氢酶水平较高外,初始呼吸状态或实验室检查值无种族差异。患者年龄和初始吸氧需求与第14天结局较差相关,但种族无关(调整后的比例优势比为0.92;95%置信区间为0.70 - 1.20)。
我们的结果表明,就诊时合并症或疾病严重程度存在微小的种族差异,且两组第14天的结局无差异。然而,住院患者中黑人所占比例过高,这表明预防措施应包括限制SARS-CoV-2在黑人社区暴露和传播的策略,作为减少与COVID-19相关的种族不平等的一步。