Lack of racial and ethnic disparities in mortality in minority patients hospitalised with COVID-19 in a mid-Atlantic healthcare system

BMJ Open Respir Res. 2024 May 1;11(1):e002310. doi: 10.1136/bmjresp-2024-002310.

Abstract

Introduction: In the USA, minoritised communities (racial and ethnic) have suffered disproportionately from COVID-19 compared with non-Hispanic white communities. In a large cohort of patients hospitalised for COVID-19 in a healthcare system spanning five adult hospitals, we analysed outcomes of patients based on race and ethnicity.

Methods: This was a retrospective cohort analysis of patients 18 years or older admitted to five hospitals in the mid-Atlantic area between 4 March 2020 and 27 May 2022 with confirmed COVID-19. Participants were divided into four groups based on their race/ethnicity: non-Hispanic black, non-Hispanic white, Latinx and other. Propensity score weighted generalised linear models were used to assess the association between race/ethnicity and the primary outcome of in-hospital mortality.

Results: Of the 9651 participants in the cohort, more than half were aged 18-64 years old (56%) and 51% of the cohort were females. Non-Hispanic white patients had higher mortality (p<0.001) and longer hospital length-of-stay (p<0.001) than Latinx and non-Hispanic black patients.

Discussion: In this large multihospital cohort of patients admitted with COVID-19, non-Hispanic black and Hispanic patients did not have worse outcomes than white patients. Such findings likely reflect how the complex range of factors that resulted in a life-threatening and disproportionate impact of incidence on certain vulnerable populations by COVID-19 in the community was offset through admission at well-resourced hospitals and healthcare systems. However, there continues to remain a need for efforts to address the significant pre-existing race and ethnicity inequities highlighted by the COVID-19 pandemic to be better prepared for future public health emergencies.

Keywords: COVID-19; Critical Care; Respiratory Infection; Viral infection.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Black or African American / statistics & numerical data
  • COVID-19* / ethnology
  • COVID-19* / mortality
  • COVID-19* / therapy
  • Ethnic and Racial Minorities / statistics & numerical data
  • Female
  • Health Status Disparities
  • Healthcare Disparities / ethnology
  • Hispanic or Latino / statistics & numerical data
  • Hospital Mortality* / ethnology
  • Hospitalization / statistics & numerical data
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Retrospective Studies
  • SARS-CoV-2*
  • United States / epidemiology
  • White
  • White People / statistics & numerical data
  • Young Adult