tetano
Editor, Senior Moderator
Sci Rep
. 2021 Apr 22;11(1):8738.
doi: 10.1038/s41598-021-88308-2.
Racial disparities in COVID-19 outcomes exist despite comparable Elixhauser comorbidity indices between Blacks, Hispanics, Native Americans, and Whites
Fares Qeadan[SUP] 1 [/SUP], Elizabeth VanSant-Webb[SUP] 2 [/SUP], Benjamin Tingey[SUP] 3 [/SUP], Tiana N Rogers[SUP] 2 [/SUP], Ellen Brooks[SUP] 3 [/SUP], Nana A Mensah[SUP] 3 [/SUP], Karen M Winkfield[SUP] 4 5 [/SUP], Ali I Saeed[SUP] 6 [/SUP], Kevin English[SUP] 7 [/SUP], Charles R Rogers[SUP] 3 [/SUP]
Affiliations
Abstract
Factors contributing to racial inequities in outcomes from coronavirus disease 2019 (COVID-19) remain poorly understood. We compared by race the risk of 4 COVID-19 health outcomes--maximum length of hospital stay (LOS), invasive ventilation, hospitalization exceeding 24 h, and death--stratified by Elixhauser comorbidity index (ECI) ranking. Outcomes and ECI scores were constructed from retrospective data obtained from the Cerner COVID-19 De-Identified Data cohort. We hypothesized that racial disparities in COVID-19 outcomes would exist despite comparable ECI scores among non-Hispanic (NH) Blacks, Hispanics, American Indians/Alaska Natives (AI/ANs), and NH Whites. Compared with NH Whites, NH Blacks had longer hospital LOS, higher rates of ventilator dependence, and a higher mortality rate; AI/ANs, higher odds of hospitalization for ECI = 0 but lower for ECI ? 5, longer LOS for ECI = 0, a higher risk of death across all ECI categories except ECI ? 5, and higher odds of ventilator dependence; Hispanics, a lower risk of death across all ECI categories except ECI = 0, lower odds of hospitalization, shorter LOS for ECI ? 5, and higher odds of ventilator dependence for ECI = 0 but lower for ECI = 1-4. Our findings contest arguments that higher comorbidity levels explain elevated COVID-19 death rates among NH Blacks and AI/ANs compared with Hispanics and NH Whites.
. 2021 Apr 22;11(1):8738.
doi: 10.1038/s41598-021-88308-2.
Racial disparities in COVID-19 outcomes exist despite comparable Elixhauser comorbidity indices between Blacks, Hispanics, Native Americans, and Whites
Fares Qeadan[SUP] 1 [/SUP], Elizabeth VanSant-Webb[SUP] 2 [/SUP], Benjamin Tingey[SUP] 3 [/SUP], Tiana N Rogers[SUP] 2 [/SUP], Ellen Brooks[SUP] 3 [/SUP], Nana A Mensah[SUP] 3 [/SUP], Karen M Winkfield[SUP] 4 5 [/SUP], Ali I Saeed[SUP] 6 [/SUP], Kevin English[SUP] 7 [/SUP], Charles R Rogers[SUP] 3 [/SUP]
Affiliations
- PMID: 33888833
- DOI: 10.1038/s41598-021-88308-2
Abstract
Factors contributing to racial inequities in outcomes from coronavirus disease 2019 (COVID-19) remain poorly understood. We compared by race the risk of 4 COVID-19 health outcomes--maximum length of hospital stay (LOS), invasive ventilation, hospitalization exceeding 24 h, and death--stratified by Elixhauser comorbidity index (ECI) ranking. Outcomes and ECI scores were constructed from retrospective data obtained from the Cerner COVID-19 De-Identified Data cohort. We hypothesized that racial disparities in COVID-19 outcomes would exist despite comparable ECI scores among non-Hispanic (NH) Blacks, Hispanics, American Indians/Alaska Natives (AI/ANs), and NH Whites. Compared with NH Whites, NH Blacks had longer hospital LOS, higher rates of ventilator dependence, and a higher mortality rate; AI/ANs, higher odds of hospitalization for ECI = 0 but lower for ECI ? 5, longer LOS for ECI = 0, a higher risk of death across all ECI categories except ECI ? 5, and higher odds of ventilator dependence; Hispanics, a lower risk of death across all ECI categories except ECI = 0, lower odds of hospitalization, shorter LOS for ECI ? 5, and higher odds of ventilator dependence for ECI = 0 but lower for ECI = 1-4. Our findings contest arguments that higher comorbidity levels explain elevated COVID-19 death rates among NH Blacks and AI/ANs compared with Hispanics and NH Whites.