Racial Disparities in COVID-19 Hospitalization and In-hospital Mortality at the Height of the New York City Pandemic
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Racial Disparities in COVID-19 Hospitalization and In-hospital Mortality at the Height of the New York City Pandemic Benjamin D. Renelus 1 & Neil C. Khoury 2 & Karthik Chandrasekaran 2 & Ezana Bekele 2 & William M. Briggs 3 Alexander Ivanov 4 & Smruti R. Mohanty 5 & Daniel S. Jamorabo 6
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Received: 19 May 2020 / Revised: 12 September 2020 / Accepted: 14 September 2020 # W. Montague Cobb-NMA Health Institute 2020
Abstract Objectives Investigate whether or not race is associated with differences in hospitalization and survival to discharge among patients with coronavirus disease-2019 (COVID-19) at the height of the pandemic in New York City (NYC). Methods Single-center retrospective cohort study of COVID-19 patients hospitalized at our university-affiliated NYC hospital from 3/10/20 through 4/13/20 with follow-up to 5/1/20. Our primary endpoint was hospitalization rate among patients with confirmed COVID-19 compared with the regional population based on race. Our secondary endpoint survival to discharge among hospitalized COVID-19 patients. NYC Department of Health data were used to calculate hospitalization odds ratios. Chi-square and t tests were used to compare categorial and continuous variables, respectively. Cox proportional hazards regression and predictive analysis were used to investigate our endpoints further. Results Our cohort of 734 patients included 355 women (48.4%), 372 Blacks (50.7%), 214 Whites (29.2%), and 92 Hispanics (12.5%) in our analysis. Blacks were nearly twice as likely as Whites to require hospitalization for COVID-19 (OR 1.89, 95% CI, 1.59–2.24, p < 0.001). Hispanics were also more likely to suffer in-hospital mortality from COVID-19 compared with Whites (HR 1.84; 95% CI 1.21–2.80; p = 0.005). There was a non-significant increased hazard of in-hospital mortality among Blacks when compared with Whites (HR, 1.30; 95% CI, 0.95–1.78; p = 0.09). Conclusions and Relevance Blacks were more likely than Whites to require hospitalization for COVID-19 while Hispanics were more likely to experience in-hospital mortality. Further investigation into the socioeconomic factors underlying racial disparities in COVID-19 survival and severity requiring hospitalization is needed on a national scale. Keywords Coronavirus disease-2019 . Racial disparities . Sex disparities . Infectious disease
Introduction * Daniel S. Jamorabo [email protected]; [email protected] 1
Division of Gastroenterology and Hepatology, Morehouse School of Medicine, Atlanta, GA, USA
2
Department of Internal Medicine, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
3
Department of Biostatistics, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
4
Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
5
Division of Gastroenterology and Hepatology, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
6
Division of Gastroenterology and Hepatology, Stony Brook Medicine, 101 Nicolls Road, HSC T17-060, Stony Brook, NY 11794, USA
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