Abstract

BackgroundThere is a dearth of epidemiological data on ethnic disparities among older patients with COVID-19. The objective of this study was to characterize ethnic differences in clinical presentation and outcomes from COVID-19 among older U.S. adults.MethodsThis was a retrospective cohort study within two geriatric emergency departments (GEDs) at a large academic health system. One hundred patients 65 years or older who visited a GED between March 10, 2020 and August 9, 2020 and tested positive for COVID-19 were examined. Electronic medical records were used to determine presenting COVID-19–related symptoms, comorbidities, and clinical outcomes. Descriptive statistics are reported with associated 95% confidence intervals (CIs).ResultsIn the overall sample, mean age was 75.9 years; 18% were 85 years or older; 50% were male; and 46.0% were Hispanic. Relative to non-Hispanic patients with COVID-19, Hispanic patients with COVID-19 had a higher percentage of shortness of breath (78.3% vs. 51.9%; difference: 26.4%; 95% CI 7.6–42.5%), pneumonia (82.6% vs. 50.0%; difference: 32.6%; 95% CI 14.1–47.9%), acute respiratory distress syndrome (13.0% vs. 1.9%; difference: 11.1%; 95% CI 0.7–23.9%), and acute kidney failure (41.3% vs. 22.2%; difference: 19.1%; 95% CI 0.9–36.0%). Rates of other poor outcomes, including hospitalization, intensive care unit (ICU) admission, return visits to the GED within 30 days of discharge, or death, did not significantly differ between Hispanic and non-Hispanic patients with COVID-19.ConclusionsThese preliminary data show that older Hispanic patients relative to non-Hispanic patients with COVID-19 presenting to a GED did not experience worse outcomes, including hospitalization, ICU admission, 30-day return visits to the GED, or death.

Highlights

  • Since the first case of coronavirus disease 2019 (COVID19) was reported in December 2019, the virus has rapidly spread worldwide, resulting in a pandemic and public health emergency

  • The percentage of obesity was significantly higher in Hispanic relative to non-Hispanic patients with COVID-19 (39.1% vs. 20.4%; difference: 18.7%; 95% confidence intervals (CIs) 0.9–35.5%)

  • We observed ethnic disparities in COVID-19 among adults 65 years and older in this preliminary and initial analysis of patients presenting to two geriatric emergency departments (GEDs) at a large academic health system

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Summary

Introduction

Since the first case of coronavirus disease 2019 (COVID19) was reported in December 2019, the virus has rapidly spread worldwide, resulting in a pandemic and public health emergency. California is one of the states most affected by COVID-19, reporting 2,391,261 cases and 26,538 deaths to date [1] Older patients and those with comorbidities (e.g., cardiovascular disease and diabetes) have been found to experience worse outcomes, such as hospitalization, death, and acute respiratory distress syndrome [2,3,4,5,6,7,8,9,10]. As of January 4, 2020, there have been 1,684,586 cases of COVID-19 and 26,333 deaths due to this disease among individuals of Hispanic ethnicity in the United States [11]. There is a dearth of epidemiological data on ethnic differences among patients with COVID-19, especially among adults 65 years and older

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