COVID-19 health inequities and association with mechanical ventilation and prolonged length of stay at an urban safety-net health system in Chicago

Abstract

Millions of Americans have been infected with COVID-19 and communities of color have been disproportionately burdened. We investigated the relationship between demographic characteristics and COVID-19 positivity, and comorbidities and severe COVID-19 illness (use of mechanical ventilation and length of stay) within a racial/ethnic minority population. Patients tested for COVID-19 between March 2020 and January 2021 (N = 14171) were 49.9% (n = 7072) female; 50.1% (n = 7104) non-Hispanic Black; 33.2% (n = 4698) Hispanic; and 23.6% (n = 3348) aged 65+. Overall COVID-19 positivity was 16.1% (n = 2286). Compared to females, males were 1.1 times more likely to test positive (p = 0.014). Compared to non-Hispanic Whites, non-Hispanic Black and Hispanic persons were 1.4 (p = 0.003) and 2.4 (p<0.001) times more likely, respectively, to test positive. Compared to persons ages 18–24, the odds of testing positive were statistically significantly higher for every age group except 25–34, and those aged 65+ were 2.8 times more likely to test positive (p<0.001). Adjusted for race, sex, and age, COVID-positive patients with chronic obstructive pulmonary disease were 1.9 times more likely to require a ventilator compared to those without chronic obstructive pulmonary disease (p = 0.001). Length of stay was not statistically significantly associated with any of the comorbidity variables. Our findings emphasize the importance of documenting COVID-19 disparities in marginalized populations.

Comparison between high-flow nasal oxygen (HFNO) alternated with non-invasive ventilation (NIV) and HFNO and NIV alone in patients with COVID-19: a retrospective cohort study

“…The presence of at least one comorbidity, chest CT score and SpO 2 /FiO 2 ratio was different in our population, because they may contribute to worse clinical outcomes regardless of ventilatory strategies [ 9 , 23 ]; correction using multivariate regression models is required. Although age [ 7 ] and SAPS-3 [ 8 ] are well-known risk factors associated with the need for IMV, we did not observe differences in our population between the groups.…”

Epidemiological profile of covid-19 in the state of espírito santo, brazil, from march 2020 to june 2021

“…These two variables were influenced by associated comorbidities and the immunosuppression presence, especially in elderly patients, with median age above 60 years 33,34 . Moreover, as the pandemic progressed, other elements became risk factors for worsening the situation, such as gender, ethnicity, particularly blacks and Hispanics and comorbidities 35 .…”