COVID-19 research briefs: social factors and co-morbidity may explain apparent higher mortality in Black people

Daily POEMs

Published: 2020-06-07 © 2020 John Wiley & Sons, Inc.

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Clinical question
Is mortality higher in Black people who develop COVID-19?

Bottom line
Adjusted in-hospital mortality from COVID-19 in Louisiana no different for Black and White patients. (LOE = 2b)

Price-Haywood EG, Burton J, Fort D, Seoane L. Hospitalization and Mortality among Black Patients and White Patients with Covid-19. N Engl J Med. 2020 May 27. doi: 10.1056/NEJMsa2011686. Epub ahead of printdoi:10.1001/jamanetworkopen.2020.11102.

Study design: Cohort (retrospective)

Setting: Population-based

Research Brief #32: In this retrospective study from a single Louisiana health care system, the association between race and hospital mortality was determined for 1,382 hospitalized patients from a cohort of 3,481 black/non-Hispanic and white/non-Hispanic COVID-19 positive patients. Of these patients, 70.4% were black/non-Hispanic and 29.6% were white/non-Hispanic. The mortality results were adjusted for age, burden of chronic disease using the Charlson Comorbidity Index, public insurance status, residence in a low-income area, and obesity, factors all associated with increased odds of hospital admission. Three hundred and twenty-six patients died during the study period. Among patients who died, 70.6% were black/non-Hispanic and 29.4% white/non-Hispanic. The unadjusted case-fatality rate was 30.1% for white patients and 21.6% for black patients. Race was not associated with higher mortality (HR 0.89 for black/non-Hispanic vs white/non-Hispanic, 95% CI, 0.68-1.17) when adjusted for the variables noted above and for severity of clinical illness at presentation to the hospital.

John Hickner, MD, MS
Professor Emeritus
Dept of Family Medicine
Michigan State University
East Lansing, MI

Copyright © 2020 John Wiley & Sons, Inc.