Differences in Inflammation, Treatment, and Outcomes Between Black and Non-Black Patients Hospitalized for COVID-19: A Prospective Cohort Study - 03/03/22
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Abstract |
Purpose |
Racial disparities in coronavirus disease 2019 (COVID-19) outcomes have been described. We sought to determine whether differences in inflammatory markers, use of COVID-19 therapies, enrollment in clinical trials, and in-hospital outcomes contribute to racial disparities between Black and non-Black patients hospitalized for COVID-19.
Methods |
We leveraged a prospective cohort study that enrolled 1325 consecutive patients hospitalized for COVID-19, of whom 341 (25.7%) were Black. We measured biomarkers of inflammation and collected data on the use COVID-19-directed therapies, enrollment in COVID-19 clinical trials, mortality, need for renal replacement therapy, and need for mechanical ventilation.
Results |
Compared to non-Black patients, Black patients had a higher prevalence of COVID-19 risk factors including obesity, hypertension, and diabetes mellitus and were more likely to require renal replacement therapy (15.8% vs 7.1%, P < .001) and mechanical ventilation (37.2% vs 26.6%, P < .001) during their hospitalization. Mortality was similar between both groups (15.5% for Blacks vs 14.0% for non-Blacks, P = .49). Black patients were less likely to receive corticosteroids (44.9% vs 63.8%, P< .001) or remdesivir (23.8% vs 57.8%, P < .001) and were less likely to be enrolled in COVID-19 clinical trials (15.3% vs 28.2%, P < .001). In adjusted analyses, Black race was associated with lower levels of C-reactive protein and soluble urokinase receptor and higher odds of death, mechanical ventilation, and renal replacement therapy. Differences in outcomes were not significant after adjusting for use of remdesivir and corticosteroids.
Conclusions |
Racial differences in outcomes of patients with COVID-19 may be related to differences in inflammatory response and differential use of therapies.
El texto completo de este artículo está disponible en PDF.Keywords : African Americans, Convalescent serum, Coronavirus, Corticosteroids, Disparities, M2C2, Remdesivir, SARS-COV-2
Esquema
| Funding: RP-B is supported by NIH/NIDDK-1-R01-DK-107956-01, NIH U01 DK119083, and Juvenile Diabetes Research Foundation. SSH is funded by NIH 1R01HL153384, U01-DK119083, R01-DK109720. and the Frankel Cardiovascular Center COVID-19: Impact Research Ignitor (U-M G024231) award. |
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| Conflicts of Interest: The wife of CW works at Regeneron Pharmaceuticals. SSH is a member of the scientific advisory board of Walden Biosciences. TUA, HB, EA, MP, HRS, KP, PO'H, CM, RF, EM, CL, PB, AB, RP-B, JMC report none. |
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| Authorship: All authors had access to the data and a role in writing this manuscript. |
Vol 135 - N° 3
P. 360-368 - mars 2022 Regresar al número
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