Hispanic ethnicity and mortality among critically ill patients with COVID-19

Abstract

Background Hispanic persons living in the United States (U.S.) are at higher risk of infection and death from coronavirus disease 2019 (COVID-19) compared with non-Hispanic persons. Whether this disparity exists among critically ill patients with COVID-19 is unknown. Objective To evaluate ethnic disparities in mortality among critically ill adults with COVID-19 enrolled in the Study of the Treatment and Outcomes in Critically Ill Patients with COVID-19 (STOP-COVID). Methods Multicenter cohort study of adults with laboratory-confirmed COVID-19 admitted to intensive care units (ICU) at 67 U.S. hospitals from March 4 to May 9, 2020. Multilevel logistic regression was used to evaluate 28-day mortality across racial/ethnic groups. Results A total of 2153 patients were included (994 [46.2%] Hispanic and 1159 [53.8%] non-Hispanic White). The median (IQR) age was 62 (51–71) years (non-Hispanic White, 66 [57–74] years; Hispanic, 56 [46–67] years), and 1462 (67.9%) were men. Compared with non-Hispanic White patients, Hispanic patients were younger; were less likely to have hypertension, chronic obstructive pulmonary disease, coronary artery disease, or heart failure; and had longer duration of symptoms prior to ICU admission. During median (IQR) follow-up of 14 (7–24) days, 785 patients (36.5%) died. In analyses adjusted for age, sex, clinical characteristics, and hospital size, Hispanic patients had higher odds of death compared with non-Hispanic White patients (OR, 1.44; 95% CI, 1.12–1.84). Conclusions Among critically ill adults with COVID-19, Hispanic patients were more likely to die than non-Hispanic White patients, even though they were younger and had lower comorbidity burden. This finding highlights the need to provide earlier access to care to Hispanic individuals with COVID-19, especially given our finding of longer duration of symptoms prior to ICU admission among Hispanic patients. In addition, there is a critical need to address ongoing disparities in post hospital discharge care for patients with COVID-19.

Rates of newly diagnosed breast cancer at commission on cancer facilities during the early phase of the COVID‐19 pandemic

“…Hispanic females had the sharpest decline from 2019 to 2020 among all races and ethnicities, with an 18.4% decrease. This is consistent with other disparities that Hispanic individuals faced during the pandemic—Hispanics had higher rates of COVID‐19 infection as well as mortality related to COVID‐19 compared to non‐Hispanic Whites 18,19,29,35,36 …”

“…This is consistent with other disparities that Hispanic individuals faced during the pandemic-Hispanics had higher rates of COVID-19 infection as well as mortality related to COVID-19 compared to non-Hispanic Whites. 18,19,29,35,36 Female patients receiving care in the western U.S. and the Middle Atlantic division experienced the largest declines in 2020, which may reflect the large COVID-19 outbreaks in New York, Washington State, and California at the time of the study period. One study examined the screening deficit for three different types of cancers using a cohort of 60 million people and also found that the Northeast region experienced the largest declines in screening.…”

Characteristics and Outcomes of 360 Consecutive COVID-19 Patients Discharged From the Emergency Department With Supplemental Oxygen

“…Nonetheless, LAC+USC Medical Center is one of the largest hospitals in the country, and the study population, which generally reflects the population served by the ED (primarily Latino, with high rates of diabetes, hypertension, and obesity), is one with high risk for adverse outcomes from COVID-19. 8 Second, findings may be limited because of inconsistencies inherent to the chart review process. However, we used a piloted structured review method and verified interrater reliability for collecting primary outcomes.…”

Exploring risk factors for persistent neurocognitive sequelae after hospitalization for COVID‐19

“…Hispanic individuals have been disproportionately adversely affected by the COVID‐19 pandemic 44 . This is a historically vulnerable group that has high rates of comorbidities, decreased access to healthcare, language barriers, food insecurity, higher rates of essential workers status, and numerous other factors that ultimately have led to worse outcomes, including higher infection rates, hospitalizations, and mortality, with COVID‐19 45 . An increased risk of adverse COVID‐19 outcomes has also been noted among Black populations 46 .…”