Abstract
As of May 11, 2020, there have been more than 290 000 deaths worldwide from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). Risk-adjusted differences in outcomes among patients of differing ethnicity and race categories are not well characterized. To investigate whether presenting comorbidities in patients with COVID-19 in New York City differed by race/ethnicity and whether case fatality rates varied among different ethnic and racial groups, controlling for presenting comorbidities and other risk factors. This cohort study included 5902 patients who presented for care to the Montefiore Medical Center, a large urban academic medical center in the Bronx, New York, between March 14 and April 15, 2020, and tested positive for SARS-CoV-2 on reverse transcription quantitative polymerase chain reaction assay. Final data collection was April 27, 2020. Patient characteristics, including self-identified ethnicity/race, age, sex, socioeconomic status, and medical comorbidities, were tabulated. Overall survival. Associations between patient demographic characteristics, comorbidities, and race/ethnicity were examined using χ2 tests, and the association with survival was assessed using univariable and multivariable Cox proportional hazards regression, based on time from positive COVID-19 test. Of 9268 patients who were tested, 5902 ethnically diverse patients (63.7%) had SARS-CoV-2. Of these, 3129 patients (53.0%) were women, and the median (interquartile range) age was 58 (44-71) years. A total of 918 patients (15.5%) died within the study time frame. Overall, 1905 patients (32.3%) identified as Hispanic; 1935 (32.8%), non-Hispanic Black; 509 (8.6%), non-Hispanic White; and 171 (2.9%), Asian; the death rates were 16.2% (309), 17.2% (333), 20.0% (102), and 17.0% (29), respectively (P = .25). Hispanic and non-Hispanic Black patients had a higher proportion of more than 2 medical comorbidities with 654 (34.3%) and 764 (39.5%), respectively, compared with 147 (28.9%) among non-Hispanic White patients (P < .001). Hispanic and non-Hispanic Black patients were also more likely to test positive for COVID-19 than White patients, with 1905 of 2919 Hispanic patients (65.3%), 1935 of 2823 non-Hispanic Black patients (68.5%), and 509 of 960 non-Hispanic White patients (53.0%) having positive test results for SARS-CoV-2 (P < .001). While controlling for age, sex, socioeconomic status and comorbidities, patients identifying as Hispanic (hazard ratio, 0.77; 95% CI, 0.61-0.98; P = .03) or non-Hispanic Black (hazard ratio, 0.69; 95% CI, 0.55-0.87; P = .002) had slightly improved survival compared with non-Hispanic White patients. In this cohort study of patients with COVID-19 who presented for care at the same urban medical center, non-Hispanic Black and Hispanic patients did not experience worse risk-adjusted outcomes compared with their White counterparts. This finding is important for understanding the observed population differences in mortality by race/ethnicity reported elsewhere.
Highlights
Hispanic and non-Hispanic Black patients were more likely to test positive for COVID-19 than White patients, with 1905 of 2919 Hispanic patients (65.3%), 1935 of 2823 non-Hispanic Black patients (68.5%), and 509 of 960 non-Hispanic White patients (53.0%) having positive test results for SARS-CoV-2 (P < .001)
While controlling for age, sex, socioeconomic status and comorbidities, patients identifying as Hispanic or non-Hispanic Black had slightly improved survival compared with non-Hispanic White patients
In a cohort study of 5902 patients with positive COVID-19 diagnosis treated at a single academic medical center in New York, non-Hispanic Black and Hispanic patients had a higher proportion of more than 2 medical comorbidities and were more likely to test positive for COVID-19 compared with their non-Hispanic White counterparts
Summary
As of May 11, 2020, there had been more than 4.1 million cases worldwide of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), with 290 000 deaths. In the United States, according to the Centers for Disease Control and Prevention (CDC), accessed on May 11, 2020, more than 1 324 000 cases had been identified, with more than 79 000 deaths recorded. Published reports are beginning to emerge characterizing the presentation of patients cared for in large health systems in New York and California. Despite this emerging evidence, a May 2020 article highlighted the lack of detailed information regarding ethnicity in reports on COVID-19 cases and outcomes.The CDC recently reported on a sample of 1482 patients with confirmed COVID-19 who were hospitalized from March 1 to 30, 2020, with race/ethnicity information for 580 of them. They found that African Americans made up 33% of the sample of hospitalized patients while they represented 18% of the catchment population. Published reports are beginning to emerge characterizing the presentation of patients cared for in large health systems in New York and California.. Published reports are beginning to emerge characterizing the presentation of patients cared for in large health systems in New York and California.3,4 Despite this emerging evidence, a May 2020 article highlighted the lack of detailed information regarding ethnicity in reports on COVID-19 cases and outcomes. The CDC recently reported on a sample of 1482 patients with confirmed COVID-19 who were hospitalized from March 1 to 30, 2020, with race/ethnicity information for 580 of them.. The CDC recently reported on a sample of 1482 patients with confirmed COVID-19 who were hospitalized from March 1 to 30, 2020, with race/ethnicity information for 580 of them.6 They found that African Americans made up 33% of the sample of hospitalized patients while they represented 18% of the catchment population. Non-Hispanic White patients made up 45% of the hospitalized sample but 59% of the residents in the sampled area.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
