tetano
Editor, Senior Moderator
PLoS One
. 2022 May 18;17(5):e0268022.
doi: 10.1371/journal.pone.0268022. eCollection 2022.
Hispanic ethnicity and mortality among critically ill patients with COVID-19
Ana C Ricardo[SUP] 1 [/SUP], Jinsong Chen[SUP] 1 [/SUP], Stephanie M Toth-Manikowski[SUP] 1 [/SUP], Natalie Meza[SUP] 1 [/SUP], Min Joo[SUP] 1 [/SUP], Shruti Gupta[SUP] 2 [/SUP], Deepa G Lazarous[SUP] 3 [/SUP], David E Leaf[SUP] 2 [/SUP], James P Lash[SUP] 1 [/SUP], STOP-COVID Investigators
Affiliations
Abstract
Background: Hispanic persons living in the United States (U.S.) are at higher risk of infection and death from coronavirus disease 2019 (COVID-19) compared with non-Hispanic persons. Whether this disparity exists among critically ill patients with COVID-19 is unknown.
Objective: To evaluate ethnic disparities in mortality among critically ill adults with COVID-19 enrolled in the Study of the Treatment and Outcomes in Critically Ill Patients with COVID-19 (STOP-COVID).
Methods: Multicenter cohort study of adults with laboratory-confirmed COVID-19 admitted to intensive care units (ICU) at 67 U.S. hospitals from March 4 to May 9, 2020. Multilevel logistic regression was used to evaluate 28-day mortality across racial/ethnic groups.
Results: A total of 2153 patients were included (994 [46.2%] Hispanic and 1159 [53.8%] non-Hispanic White). The median (IQR) age was 62 (51-71) years (non-Hispanic White, 66 [57-74] years; Hispanic, 56 [46-67] years), and 1462 (67.9%) were men. Compared with non-Hispanic White patients, Hispanic patients were younger; were less likely to have hypertension, chronic obstructive pulmonary disease, coronary artery disease, or heart failure; and had longer duration of symptoms prior to ICU admission. During median (IQR) follow-up of 14 (7-24) days, 785 patients (36.5%) died. In analyses adjusted for age, sex, clinical characteristics, and hospital size, Hispanic patients had higher odds of death compared with non-Hispanic White patients (OR, 1.44; 95% CI, 1.12-1.84).
Conclusions: Among critically ill adults with COVID-19, Hispanic patients were more likely to die than non-Hispanic White patients, even though they were younger and had lower comorbidity burden. This finding highlights the need to provide earlier access to care to Hispanic individuals with COVID-19, especially given our finding of longer duration of symptoms prior to ICU admission among Hispanic patients. In addition, there is a critical need to address ongoing disparities in post hospital discharge care for patients with COVID-19.
. 2022 May 18;17(5):e0268022.
doi: 10.1371/journal.pone.0268022. eCollection 2022.
Hispanic ethnicity and mortality among critically ill patients with COVID-19
Ana C Ricardo[SUP] 1 [/SUP], Jinsong Chen[SUP] 1 [/SUP], Stephanie M Toth-Manikowski[SUP] 1 [/SUP], Natalie Meza[SUP] 1 [/SUP], Min Joo[SUP] 1 [/SUP], Shruti Gupta[SUP] 2 [/SUP], Deepa G Lazarous[SUP] 3 [/SUP], David E Leaf[SUP] 2 [/SUP], James P Lash[SUP] 1 [/SUP], STOP-COVID Investigators
Affiliations
- PMID: 35584148
- DOI: 10.1371/journal.pone.0268022
Abstract
Background: Hispanic persons living in the United States (U.S.) are at higher risk of infection and death from coronavirus disease 2019 (COVID-19) compared with non-Hispanic persons. Whether this disparity exists among critically ill patients with COVID-19 is unknown.
Objective: To evaluate ethnic disparities in mortality among critically ill adults with COVID-19 enrolled in the Study of the Treatment and Outcomes in Critically Ill Patients with COVID-19 (STOP-COVID).
Methods: Multicenter cohort study of adults with laboratory-confirmed COVID-19 admitted to intensive care units (ICU) at 67 U.S. hospitals from March 4 to May 9, 2020. Multilevel logistic regression was used to evaluate 28-day mortality across racial/ethnic groups.
Results: A total of 2153 patients were included (994 [46.2%] Hispanic and 1159 [53.8%] non-Hispanic White). The median (IQR) age was 62 (51-71) years (non-Hispanic White, 66 [57-74] years; Hispanic, 56 [46-67] years), and 1462 (67.9%) were men. Compared with non-Hispanic White patients, Hispanic patients were younger; were less likely to have hypertension, chronic obstructive pulmonary disease, coronary artery disease, or heart failure; and had longer duration of symptoms prior to ICU admission. During median (IQR) follow-up of 14 (7-24) days, 785 patients (36.5%) died. In analyses adjusted for age, sex, clinical characteristics, and hospital size, Hispanic patients had higher odds of death compared with non-Hispanic White patients (OR, 1.44; 95% CI, 1.12-1.84).
Conclusions: Among critically ill adults with COVID-19, Hispanic patients were more likely to die than non-Hispanic White patients, even though they were younger and had lower comorbidity burden. This finding highlights the need to provide earlier access to care to Hispanic individuals with COVID-19, especially given our finding of longer duration of symptoms prior to ICU admission among Hispanic patients. In addition, there is a critical need to address ongoing disparities in post hospital discharge care for patients with COVID-19.