Disparity in the COVID-19 Era: Elevated Liver Enzymes, Ferritin, CRP, D-Dimer, and Age are Predictive Markers of Outcomes Among COVID-19 African Americans and Hispanic Patients

Abstract

Background: The coronavirus disease 2019 (COVID-19) disproportionately affected African Americans and Hispanics. Aim: We sought to determine clinical and gastrointestinal (GI) factors associated with differences in outcomes. Methods: Analyses of symptoms, comorbidities correlations with mortality were performed were performed on 399 patients’ data. Findings: There were 257 (63.7%) African Americans (AAs), 102 (25.3%) Hispanics, 26 (6.45%) Whites and 14 (3.5%) other races. The mean age was 55.6 years (SD = 18.5). However, the mean age of Hispanics was the lowest (43.7 years vs. 61.2 for Whites vs. 60 for AAs). The total number of deaths was 64 (16%). There was a higher mortality among patients with cardiac diseases (25.7% vs. 14.3%; P = 0.018) and Immunocompromised patients (28.5% vs. 15.3%; P = 0.044). Patients with shortness of breath (21.6% vs. 7.3%; P <0.001), and mechanical ventilation (70.2% vs. 5.1%; P <0.001) had a high mortality rate. Cough and fever were common, but unrelated to outcome. Hydroxychloroquine treatment was not associated with better prognosis while glucocorticoid associated with had higher mortality (39.1% vs. 11.8%; P <0.001). Diarrhea was prevalent (18.8%). Elevated Creatinine, Ferritin, CRP, liver enzymes and D-dimers associated with higher mortality. Interpretations: African Americans in our study had the highest mortality as they consisted of an older population. Age is the most important factor along with cardiac disease, SOB, and immunocompromised status in determining the mortality rate. Overall, elevated liver enzymes, ferritin, CRP and D-dimer were associated with poor prognosis. Attention should also be paid to monitor liver function during the course of COVID-19, especially in African Americans and Hispanic patients with higher disease severity. Funding Statement: This project was supported (in part) by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number G12MD007597. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Declaration of Interests: No potential conflicts of interest are disclosed. Ethics Approval Statement: This study was approved by Howard University Institutional Review Board.