Risk Factors for In-hospital Mortality from COVID-19 Infection among Black Patients – An Urban Center Experience
September 28, 2020
Bhargava A., Sharma M., Riederer K., et al.
Clinical Infectious Diseases
Racial disparities have become central in the national conversation about COVID-19. Understanding the clinical risk factors and laboratory biomarkers associated with severe and fatal COVID-19 among the black population in a community setting will allow early interventions to mitigate adverse outcomes. Our study aims to identify risk factors for death from the COVID-19 infection among hospitalized black patients at Ascension St. John Hospital in Detroit, Michigan. We conducted a single-center, retrospective cohort study tertiary care academic medical center from March 8th to May 6th, 2020 were included. A total of 419 hospitalized black patients with confirmed SARS-CoV-2 infections were included. Electronic medical records (EMR) were reviewed for all the patients meeting inclusion criteria. The in-hospital case fatality rate (CFR) among black patients was 29.1% (122/419). In our cohort, clinical predictors associated with higher deaths among blacks were Charlson comorbidity index, the presentation with altered mental status (AMS), the requirement for intubation, development of shock, and ARDS. The need for mechanical ventilation (MV) was the strongest predictor for mortality in our study. Among laboratory biomarkers, elevated CRP on admission was associated with a higher risk of death. Our study has several limitations, was a single-institution study of admitted patients, which makes generalization difficult. These demographic, clinical, and laboratory findings should alert healthcare providers to identify black patients at the highest risk for severe COVID-19 associated outcomes. Subsequent research with a more extensive database may validate our conclusions and aid early clinical decision making.
Bhargava A., Sharma M., Riederer K., Fukushima E. Risk Factors for In-hospital Mortality from COVID-19 Infection among Black Patients – An Urban Center Experience. Clinical Infectious Diseases 2020, ciaa1468,