Clinical Characteristics and Predictors of Mortality in African Americans with COVID-19 from an Inner-City Community Hospital in New York

Abstract

Background: There is limited data on the clinical presentation and predictors of mortality in the African-American (AA) patients hospitalized with COVID-19 despite the disproportionately higher burden and mortality. The aim of this study is to report on the clinical characteristics and the predictors of mortality in hospitalized AA patients with COVID-19 infection. Methods: In this retrospective cohort review, we included all AA patients with confirmed COVID-19 infection admitted to an inner-city teaching community hospital in New York City. Demographics, clinical presentation, baseline co-morbidities, and laboratory data were compared between survivors and non-survivors. The predictors of mortality were assessed using multivariate logistic regression analysis. Results: Of the 408 (median age, 67years) patients included, 276(66.65%, median age 63years) survived while 132(33.35%, median age 71years) died. The most common presenting symptoms were cough, myalgia, fever/chills, shortness of breath, and gastrointestinal symptoms (nausea, vomiting, diarrhea, and abdominal pain), with a prevalence of 62.50%, 43.87%, 53.68%, and 27.21%, respectively. Age (OR 1.06, CI 1.04-1.08, P-<0.001), body mass index (OR 1.07, CI 1.04-1.11, P-<0.001), elevated serum ferritin(OR 1.99, CI 1.08-3.66, P-0.02), C-reactive protein (OR 2.42, CI 1.36-4.33, P-0.01), and D-dimers(OR 3.79, CI 2.21-6.50, P-<0.001) at the time of presentation were identified as the independent predictors of mortality. Conclusions: Cough, shortness of breath, fever/chills, gastrointestinal symptoms, and myalgia were the predominant presentation among African-Americans hospitalized with COVID-19 infection. Advanced age, higher BMI, elevated ferritin, C-reactive protein, and D-dimers are independent predictors of mortality among hospitalized African-Americans with COVID-19 infection. Funding Statement: There was no funding for the study. Declaration of Interests: No conflict of interest for all the authors. Ethics Approval Statement: Ethical clearance was obtained from the hospital's IRB committee. Because our study was limited to chart review with no patient interactions, the requirement for informed consent was waived.