Racial and Ethnic Differences and Clinical Outcomes of COVID-19 Patients Presenting to the Emergency Department

April 1, 2021

Zanthia Wiley Katie Ross-Driscoll Zhensheng Wang Laken Smothers Aneesh K Mehta Rachel E Patzer

Clinical Infectious Diseases

The United States (US) currently leads the world in confirmed COVID-19 cases and deaths and the pandemic has disproportionately affected non-Hispanic Black (Black) and Hispanic White (Hispanic) communities. The purpose of this study is to evaluate differences in hospitalization of patients who present to the ED and differences in clinical outcomes between COVID-19 Black, White, and Hispanic White (Hispanic) patients hospitalized from the ED. The source population for this study came from the Cerner Real World Data COVID database from 12/01/2019 and included follow-up data through 09/30/2020. Black and Hispanic patients comprised nearly two-thirds (60.3%) of all patients in this cohort who presented to the ED with COVID-19, which is a substantial overrepresentation compared to the general population of Blacks (13.4%) and Hispanics (18.5%) in the US. While our study did not find that Black or Hispanic patients had higher risk of hospitalization, we did observe increased in-hospital mortality compared to Whites. The overrepresentation of Black and Hispanic patients in this study suggests that COVID-19 racial disparities are due to higher risk for exposure due to social, rather than biologic factors. Social determinants of health that contribute to these disparities include economic instability, lack of access to education, healthcare inequities, the patients’ neighborhood, and their social and community support.As treatments for COVID-19 continue to advance, special attention must be paid to ensuring equity in treatment decisions to avoid exacerbating racial disparities

Wiley Z., Ross-Driscoll K., Wang Z., Smothers L. Racial and Ethnic Differences and Clinical Outcomes of COVID-19 Patients Presenting to the Emergency Department. Clinical Infectious Diseases 2021, https://doi.org/10.1093/cid/ciab290

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