Black patients double odds for coronavirus hospital admission, study says
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A new study found that the odds of coronavirus hospital admission were nearly doubled if a patient is black.
The study, published on May 27 in the New England Journal of Medicine, set out to find more information about racial and ethnic differences in outcomes from COVID-19. Researchers compared clinical characteristics and hospital course of lab-confirmed cases in black non-Hispanic patients to white non-Hispanic patients.
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In a large Louisiana cohort of patients at Ochsner Health, researchers found that 76.9 percent of COVID-19 hospitalized patients, and 70.6 percent of fatalities, were black, while blacks comprise only 31 percent of the health care system’s population.
However, blacks weren't independently associated with higher mortality than whites after adjustment for differences in sociodemographic and clinical characteristics on admission, researchers say.
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The study concluded that in multivariable analyses, black race, older age, public insurance, residence in a low-income area and obesity were associated with higher odds of hospital admission.
The findings support demographic data on COVID-19 cases released by the New York City Department of Health earlier this month, which shows rates of coronavirus hospilizations among New York City "Black/African-American" patients exceed all other races and ethnicities at 650.3 cases per 100,000 people. Hispanic/Latino patients follow closely behind at 589.06 per 100,000 whereas white patients are reportedly hospitalized at a rate of 290.94 cases per 100,000 people.
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The NYC data confirmed the direct correlation between poverty and cases, hospitalizations and deaths, with cases ticking higher as financial circumstances worsen.
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In the Louisiana study, the percentage of black patients with Medicaid insurance was three times as high as the percentage of white non-Hispanic patients, and black patients were almost twice as likely to live in low-income areas as white patients. Black patients had higher prevalence of obesity, diabetes, hypertension, and chronic kidney disease than white patients.
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Regardless of race, the most common acute medical conditions observed throughout hospitilzation were hypoxic respiratory failure and pneumonia coinfection. Also, the average length of hospital stay was similar across racial groups.
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Researchers did report a higher percentage of black patients with acute renal failure during hospitalization when compared to white patients (15.3 percent and 10.7 percent, respectively). The vast majority of patients in the intensive care unit were black. In addition, 81.6 percent of 364 patients who received mechanical ventilation were black patients.
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Despite several noted limitations, the study authors say the research sheds light on otherwise epidemiologic characteristics of black non-Hispanic patients who, they say, are otherwise underrepresented in medical literature.