Black patients may be at increased risk of COVID-19 hospitalization and death
Disparities in health outcomes and healthcare quality related to patient skin color, particularly among non-Hispanic black patients, have been well-documented. COVID-19 has also been reported to disproportionately affect black patients. A recent retrospective cohort study included 3,481 patients (mean age 54 years) with confirmed COVID-19 receiving care in an integrated-delivery health system (Ochsner Health) in New Orleans, Louisiana. Of these patients, 70.4% were non-Hispanic black and 29.6% were non-Hispanic white. Notably, black patients make up only 31% of the patients routinely cared for by Ochsner Health. The study excluded patients with COVID-19 who were not black or white or who did not have race/ethnicity data available.
The primary outcomes analyzed were hospitalization and in-hospital mortality. Black patients had an increased risk of hospitalization in an analysis adjusted for other factors associated with increased odds of hospitalization, including older age, male sex, obesity, residence in a low-income area, and insurance with Medicare or Medicaid (adjusted odds ratio 1.96, 95% CI 1.62-2.37). Among all COVID-19 cases, 70.4% occurred in black patients, and among all patients dying from COVID-19, 70.6% were black. Black patients were not at a higher risk of death after adjustment for age and sex (adjusted hazard ratio vs. white patients 0.89, 95% CI 0.68-1.17). Among deceased patients, black patients were twice as likely to have been treated with mechanical ventilation (73.9% vs. 36.5%).
Reference: N Engl J Med. 2020 May 27