Abstract P028: Do Increased Cardiovascular Comorbidities Explain Excess Covid-19 Morbidity And Mortality In African Americans?

Abstract

Introduction: Racial disparities in COVID-19 incidence, severity and mortality have been widely reported, with African Americans (AA) suffering disproportionately compared to White Americans (WA), but the epidemiological basis for these observations remains poorly understood. We hypothesize that AA have an excess of comorbid cardiovascular conditions compared to WA, accounting for the disparity in COVID-19 infection and death. Methods: We examined 63545 laboratory-confirmed COVID-19 cases from the One Florida Research Consortium’s sample of recipients of healthcare in Florida from January 2020 to April 2021. We assessed the prevalence of preexisting comorbid conditions, behavioral risk factors, and outcomes of AA, WA, and Hispanic patients testing positive for COVID-19. Outcomes were defined as admission to ICU or all-cause death in the index admission. Associations between risk factors and outcomes were evaluated using multivariate logistic regression analysis. Results: Compared to WA, Hispanic and AA COVID-19 patients were younger, more females, and more uninsured. AA patients with COVID-19 had the highest burden of comorbidities (especially cardiovascular), and worse combined comorbidity scores. They also had a higher rate of ICU admission and death. After adjustment for multiple variables, AA patients continued to have the highest adverse outcomes risk (OR=1.44; P < 0.001; Figure 1). Other significant predictors in the model included age, sex, poverty, cardiovascular comorbidities, cancer, and mental health disorders. Conclusions: Excess comorbidities from cardio-metabolic diseases exist in AA patients with COVID-19, who also suffer excess COVID-19 outcomes. However, these cardiovascular comorbidities did not account for all the risk of adverse COVID-19 outcomes. Reasons for the excess residual risk of in AA even after adjusting for comorbidities and other risk factors require further investigation, such as mediation analyses.