The association of race and COVID-19 mortality

Abstract

Background COVID-19 mortality disproportionately affects the Black population in the United States (US). To explore this association a cohort study was undertaken. Methods We assembled a cohort of 505,992 patients receiving ambulatory care at Bronx Montefiore Health System (BMHS) between 1/1/18 and 1/1/20 to evaluate the relative risk of hospitalization and death in two time-periods, the pre-COVID time-period (1/1/20–2/15/20) and COVID time-period (3/1/20–4/15/20). COVID testing, hospitalization and mortality were determined with the Black and Hispanic patient population compared separately to the White population using logistic modeling. Evaluation of the interaction of pre-COVID and COVID time periods and race, with respect to mortality was completed. Findings A total of 9,286/505,992 (1.8%) patients were hospitalized during either or both pre-COVID or COVID periods. Compared to Whites the relative risk of hospitalization of Black patients did not increase in the COVID period (p for interaction=0.12). In the pre- COVID period, compared to Whites, the odds of death for Blacks and Hispanics adjusted for comorbidity was statistically equivalent. In the COVID period compared to Whites the adjusted odds of death for Blacks was 1.6 (95% CI 1.2–2.0, p = 0.001). There was a significant increase in Black mortality risk from pre-COVID to COVID periods (p for interaction=0.02). Adjustment for relevant clinical and social indices attenuated but did not fully explain the observed difference in Black mortality. Interpretation The BMHS COVID experience demonstrates that Blacks do have a higher mortality with COVID incompletely explained by age, multiple reported comorbidities and available metrics of sociodemographic disparity. Funding N/A

Characteristics and Factors Associated with COVID-19 Infection, Hospitalization, and Mortality Across Race and Ethnicity

“…The significant associations of minority races/ethnicities with SARS-CoV-2 infection and COVID-19-related hospitalization builds on previous analyses of Black and Hispanic patients (24)(25)(26)(27). However, unlike previous studies, we found a significant association between Hispanic race/ethnicity and hospital mortality among older patients.…”

Racial Disparities in COVID-19 Hospitalization and In-hospital Mortality at the Height of the New York City Pandemic

“…This finding is similar to outcomes identified in other NYC boroughs. Golestaneh et al found that Blacks and Hispanics with COVID-19 were more likely than Whites with COVID-19 to require hospitalization, but in-hospital mortality was equivalent across all three groups [19]. The authors also observed that both Hispanics and Blacks were more likely to test positive for SARS-CoV-2 than Whites, even when adjusting for medical comorbidities and sociodemographic factors, thereby hinting at a greater risk for SARS-CoV-2 exposure among these minority groups compared with Whites.…”

“…The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has tested the infrastructure of health systems worldwide. At the writing of this article, over 5 million people nationwide have been confirmed to be infected with coronavirus disease-2019 (COVID- 19), the illness caused by SARS-CoV-2 [1]. The mortality rate for COVID-19 remains more than 10 times higher than that of influenza despite the lower prevalence rate [1][2][3].…”

COMPARATIVE ANALYSIS OF COVID-19 MORTALITY IN BRAZIL, RIO DE JANEIRO, CAMPOS DOS GOYTACAZES, MACAÉ, CABO FRIO AND RIO DAS OSTRAS1

“…We believe that our results and analyzes on the race/color factor should be considered incipient and encourage further studies 19,20 . The analysis of COVID-19 mortality among race/color groups is more complex, as this population division is more subjective and performed differently in different situations.…”