Characteristics and clinical outcomes of COVID‐19 patients in an underserved‐inner city population: A single tertiary center cohort

Abstract

Background There is limited information describing the characteristics and clinical outcomes of patients infected with coronavirus disease 2019 (COVID‐19) especially those in underserved urban area with minority population in the United States. Methods This is a retrospective single center study for patients who were admitted with COVID‐19 infection. Data collection was from March 1 through April 24,2020. Demographic, clinical, laboratory, and treatment data were presented using descriptive statistics and frequencies. Chi‐square test and multivariate logistic regression were used to determine association of risk factors and clinical outcomes. Results A total of 242 inpatients were included with a mean age of 66 ±14.75 (±SD). 50% were female and 70% were African American. Comorbidities included hypertension (74%), diabetes mellitus (49%), and 19% had either COPD or asthma. Older age was associated with higher risk of inpatient death OR 1.056 [95% CI 1.023 to 1.090; p=0.001]. Inpatient mortality occurred in 70% who needed mechanical ventilation (OR: 29.51; 95% CI: 13.28‐65.60; p<0.0001), 58% who required continuous renal replacement therapy/hemodialysis (CRRT/HD) (OR: 6.63; 95% CI: 2.74‐16.05; p<0.0001), and 69% who needed vasopressors (OR: 30.64; 95% CI: 13.56 to 69.20; p<0.0001). Amongst biomarkers of disease severity, only baseline CRP levels (145±116 mg/L) were associated with mortality OR 1.008 [95% CI 1.003 to 1.012; p=0.002]. Conclusion Majority of hospitalized patients had hypertension and diabetes. Older age was an independent risk factor for inpatient mortality. Requirement of mechanical ventilation, vasopressor use, and CRRT/HD were associated significantly with inpatient mortality. Higher baseline CRP was significantly associated with inpatient death. This article is protected by copyright. All rights reserved.

Racial and Ethnic Disparities in COVID-19–Related Infections, Hospitalizations, and Deaths

“…In contrast to overall mortality, which reflects deaths due to diagnosed and undiagnosed COVID-19, case fatality reflects deaths among those with confirmed COVID-19. Evidence from 15 cohort and cross-sectional studies (2 good-quality, 10 fair-quality, and 3 poor-quality) suggests that there is not disparity in case fatality by race/ethnicity ( Table 2 ) ( 19 , 32 , 34 , 38 , 39 , 41 , 43 , 44 , 47 , 49 , 50 , 52–54 , 70 ). We have moderate confidence in this finding for African-American/Black and Hispanic populations.…”

The association between COVID‐19 and asthma: A systematic review and meta‐analysis

“…Finally, a total of 14 publications representing data from 17 694 participants were included in this meta-analysis. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] The sample size of patients ranged from 69 to 9946. Six studies were from America, two studies from Mexico, two studies from China and four studies from other countries.…”

Perspectives on Glucocorticoid treatment of COVID-19: a systematic review

“…All of them are retrospective observational studies. 12 were performed in China (13-26), 1 in Spain (25) and 1 in the United States (26). These studies included only patients infected with SARS-CoV-2 con rmed by RT-PCR, involving 2,713 participants.…”

“…By stratifying the interpretation of results according to the type of outcome, we can draw more secure conclusions associated with a careful individual analysis of the articles. Eight articles evaluated mortality as an outcome (13,16,18,19,22,(24)(25)(26), of these, two did not present statistical analysis and, therefore, were not included in this discussion (18,24). Two cohorts, in spite of expressing the p value attached to the table, did not show signi cance between the variables, thereby they were not inserted as well (13,19).…”

“…Two cohorts, in spite of expressing the p value attached to the table, did not show signi cance between the variables, thereby they were not inserted as well (13,19). Among the remaining four, two included patients in any disease state and found results against the use of GC (16,26). Cruz et al included only critically ill patients and used GC administration as exposure, bringing a stronger conclusion, in addition to having the highest note in the NOS score among those included (25).…”