| |
COVID-19 More Severe in Hispanics,
Blacks in Chicago Safety-Net Hospital
|
| |
| |
IAS COVID-19 Conference, July 10-11, 2020
Mark Mascolini
In a Chicago safety-net hospital, Hispanics and blacks had substantially higher proportions of COVID-19 patients with severe disease than did whites [1]. Over the March 18 to April 30, 2020 study period, Hispanics accounted for an ever-growing proportion of cases in this inner-city hospital, while proportions of blacks dropped.
Cook County, the home of Chicago, had the largest number of SARS-CoV-2 infections in the United States in the first several months of the US epidemic. The county had the fourth highest total COVID-19 deaths in the United States. Throughout the country, the COVID-19 pandemic has disproportionately affected racial and ethnic minorities.
Clinician-researchers at Chicago’s John Stroger Hospital, a large safety-net hospital, conducted this retrospective chart review to analyze demographics and clinical characteristics of its COVID-19 inpatients.
The analysis involved everyone 18 years or older admitted to John Stroger Hospital with lab-confirmed COVID-19 from March 18 to April 30, 2020. The researchers divided the study period into 7 weeks to chart trends; they rated COVID-19 severity on the following scale: Mild: Oxygen saturation greater than 94% on room air. no x-ray evidence of disease; Moderate: Oxygen saturation greater than 94% on room air, x-ray evidence of disease; Severe: Oxygen saturation at or below 94% on room air, x-ray evidence of disease; Critical: Severe criteria plus positive evidence of multiorgan failure or acute respiratory distress syndrome.
During the study period the John Stroger Hospital admitted 422 adults with COVID-19, 70% of them men, 52% Hispanic, 41% black, and 9% white. Median age stood at 55 years. Proportions admitted with mild, moderate, severe, and critical disease differed distinctly between whites and nonwhite groups:
-- Whites: 48% mild, 26% moderate, 22% severe, 4% critical
-- Blacks: 25% mild, 30% moderate, 44% severe, 2% critical
-- Hispanics: 8% mild, 30% moderate, 53% severe, 2% critical
Overall mortality of 10% did not differ between racial/ethnic groups. Whites accounted for 11% of COVID-19 admissions in the first week, and that proportion dwindled to 2% by week 6 and to 0% by week 7. Blacks accounted for 83% of COVID-19 admissions in week 1, and that proportion waned consistently over the next 6 weeks to 60%, 60%, 44%, 27%, 21%, and 9%. Over the same 7 weeks, Hispanics made up an ever-growing proportion of COVID-19 admissions: 0%, 27%, 33%, 43%, 65%, 77%, and 91%. Over the 7-week study period, proportions of COVID-19 admissions of Asians sank from 6% to 0%.
The clinician researchers conclude that COVID-19 disproportionately affects people of color in their Chicago population. They speculate that difficulties maintaining social distancing and staying home because of economic factors “may be driving the severity and sequential spread of disease in the Hispanic population.” San Francisco researchers also presented data at the IAS COVID-19 Conference that led them to the same conclusions about Hispanics [2].
References
1. Parra-Rodriguez L, et al. Racial and ethnic disparities in COVID-19 admissions in a safety-net health system in Chicago. IAS COVID-19 Conference, July 10-11, 2020. Track E. https://cattendee.abstractsonline.com/meeting/9307/Session/625
2. Chamie G, et al. High prevalence of asymptomatic SARS-CoV-2 infection found in a Latinx population in San Francisco in a mass testing campaign. IAS COVID-19 Conference, July 10-11, 2020. Track C. https://cattendee.abstractsonline.com/meeting/9307/Session/622
|
|
| |
| |
|
|
|
