Upon hospitalization, black patients with COVID-19 have a lower risk of death than whites

Studies have shown that black and hispanic patients are more likely to test positive for COVID-19, but the NYU Langone Health research team found that black patients (and others) were admitted to the hospital. (After managing their serious health and neighborhood income) is less likely to be seriously ill, dead, or discharged to hospice than white patients.

Study — Recently published online JAMA network open -According to the author, he was one of the first to investigate the effects of comorbidities and neighboring socioeconomic status (SES) on outcomes of black, Hispanic, and Asian patients admitted with COVID-19. The findings show that black and Hispanic populations are less susceptible to the inherently poorer COVID-19 results than other groups, and when hospitalized, the results are equal to or better than the white population. It shows that.

“We know that the black and Hispanic population accounts for an disproportionate proportion of COVID-19-related deaths. Population size In New York and major cities across the country, “said Gbenga Ogedegube, MD, MPH, Dr. Adolf and Margaret Berger, NYU Langone Health Professor of Medicine and Population Health, and the lead author of the study. We found that black and Hispanic patients were less likely to be hospitalized throughout NYU Langone than white patients. In short, we need to look at other structural factors that are negatively impacting the results of these communities.These factors include poor housing conditions and unequal access. Health care, Differences in employment opportunities, poverty, and we need to deal with them, “said Ogedegbe, director of the Institute for Health Inequalities at NYU Langone.

How to carry out the survey

The research team found NYU Langone Health of 9,722 patients who were tested for COVID-19 at 260 outpatient clinics in the healthcare system and four acute care hospitals in Manhattan, Brooklyn, and Long Island during March 1. All data was obtained from the Electronic Health Record (EHR) of. We tracked them until 2020, April 8, 2020, and May 13, 2020. Patient racial and ethnic data were self-reported.

For all patients who tested positive for COVID-19, researchers included race / ethnic data, body mass index (BMI), patient characteristics such as age and gender, and a weighted index of seven indicators. We have compiled data on neighborhood socio-economics (SES) (among others, median household income, education level, housing value, etc.).

Survey results

Of the 4,843 patients who tested positive for the COVID-19 test, 39% were Caucasian, 15.7% were Black, 25.9% were Hispanic, 7% were Asian, and 7.4% were multi-ethnic / other. 2,623 patients were hospitalized.

Of the 2,623 hospitalized patients, 39.9% were white, 14.3% were black, 27.3% were Hispanic, 6.9% were Asian, and 7.9% were multi-ethnic / other. Inpatients were older and had more comorbidities than those who received positive test results but were not hospitalized. As of May 13, 2020, 70.8% were discharged, 36.3% experienced serious illness, 24.7% died or were discharged to hospice, and 4.5% remained hospitalized.

Black and Hispanic patients had a lower risk of serious illness and were less likely to die or be discharged to hospice than white patients. After adjusting for age, gender, insurance status, and comorbidities, black patients remained at lower risk of death compared to white patients, while Hispanic and Asian patients had similar rates to white patients.

After adjusting for all of the above factors, Asian patients were more likely to be hospitalized than Caucasian patients, even though they were less likely to receive a positive COVID-19 test.

“Our findings provide more evidence that social determinants of health play an important role in determining patient outcomes, especially before black patients arrive in hospital.” Said Joseph E. Ravenell, Associate Professor of the Department of Population. NYU Langone Diversity Affairs and Inclusion Health and Associate Dean.

“But we’re looking at the paradox a bit,” says Dr. Ravenel. “Consistent with other studies, when black patients with COVID-19 arrived at the hospital, they found that their mortality rates were as follows, even though they came from low-income areas. Caucasian patient.. Meanwhile, it is also known that blacks and Hispanics are disproportionately infected with COVID-19 and die nationwide. “

According to Dr. Ogedegbe and Dr. Ravenell, the black population is more likely to be uninsured and uninsured than the white population, and therefore may die at home rather than in the hospital due to poor access to care. Will be higher. Another predictor of poor outcome in patients admitted with COVID-19 is male gender. In this particular study cohort, 62% of black inpatients were female, which could explain their relatively good results.The study population may not represent New York City as a whole population, They say.

The senior author of the study, Dr. Leola Holwitz, is an associate professor at the School of Population and Health Medicine, director of the Healthcare Innovation and Delivery Science Center at NYU Langone, and future research on racial and racial structural structures. It states that the direct effects of inequality need to be better investigated. Ethnic disparities in COVID-19-related hospitalization, morbidity, and mortality.