Abstract
Racial and ethnic minority groups are disproportionately affected by COVID-19. To evaluate whether rates of severe COVID-19, defined as hospitalization, intensive care unit (ICU) admission, or in-hospital death, are higher among racial and ethnic minority groups compared with non-Hispanic White persons. This cross-sectional study included 99 counties within 14 US states participating in the COVID-19-Associated Hospitalization Surveillance Network. Participants were persons of all ages hospitalized with COVID-19 from March 1, 2020, to February 28, 2021. Laboratory-confirmed COVID-19-associated hospitalization, defined as a positive SARS-CoV-2 test within 14 days prior to or during hospitalization. Cumulative age-adjusted rates (per 100 000 population) of hospitalization, ICU admission, and death by race and ethnicity. Rate ratios (RR) were calculated for each racial and ethnic group compared with White persons. Among 153 692 patients with COVID-19-associated hospitalizations, 143 342 (93.3%) with information on race and ethnicity were included in the analysis. Of these, 105 421 (73.5%) were 50 years or older, 72 159 (50.3%) were male, 28 762 (20.1%) were Hispanic or Latino, 2056 (1.4%) were non-Hispanic American Indian or Alaska Native, 7737 (5.4%) were non-Hispanic Asian or Pacific Islander, 40 806 (28.5%) were non-Hispanic Black, and 63 981 (44.6%) were White. Compared with White persons, American Indian or Alaska Native, Latino, Black, and Asian or Pacific Islander persons were more likely to have higher cumulative age-adjusted rates of hospitalization, ICU admission, and death as follows: American Indian or Alaska Native (hospitalization: RR, 3.70; 95% CI, 3.54-3.87; ICU admission: RR, 6.49; 95% CI, 6.01-7.01; death: RR, 7.19; 95% CI, 6.47-7.99); Latino (hospitalization: RR, 3.06; 95% CI, 3.01-3.10; ICU admission: RR, 4.20; 95% CI, 4.08-4.33; death: RR, 3.85; 95% CI, 3.68-4.01); Black (hospitalization: RR, 2.85; 95% CI, 2.81-2.89; ICU admission: RR, 3.17; 95% CI, 3.09-3.26; death: RR, 2.58; 95% CI, 2.48-2.69); and Asian or Pacific Islander (hospitalization: RR, 1.03; 95% CI, 1.01-1.06; ICU admission: RR, 1.91; 95% CI, 1.83-1.98; death: RR, 1.64; 95% CI, 1.55-1.74). In this cross-sectional analysis, American Indian or Alaska Native, Latino, Black, and Asian or Pacific Islander persons were more likely than White persons to have a COVID-19-associated hospitalization, ICU admission, or in-hospital death during the first year of the US COVID-19 pandemic. Equitable access to COVID-19 preventive measures, including vaccination, is needed to minimize the gap in racial and ethnic disparities of severe COVID-19.
Highlights
IntroductionThe coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected racial and ethnic minority populations in the United States, who are at an increased risk of infection, hospitalization, and death.[1,2] During the first 4 months of the pandemic, data from the US Centers for Disease Control and Prevention (CDC) COVID-19–Associated Hospitalization Surveillance Network (COVID-NET)[3,4,5] and other studies demonstrated that non-Hispanic Black persons were disproportionately hospitalized with COVID-19 and that racial and ethnic minority populations, including non-Hispanic Black and Hispanic or Latino persons, had higher rates of hospitalization compared with non-Hispanic White persons.[6,7,8] data on severe COVID-19 illness among other racial and ethnic minority groups, especially non-Hispanic American Indian or Alaska Native and non-Hispanic Asian or Pacific Islander populations, and longitudinal data across all racial and ethnic groups are limited
Compared with White persons, American Indian or Alaska Native, Latino, Black, and Asian or Pacific Islander persons were more likely to have higher cumulative age-adjusted rates of hospitalization, intensive care unit (ICU) admission, and death as follows: American Indian or Alaska Native; Latino; Black; and Asian or Pacific Islander
Racial and Ethnic Disparities in COVID-19 Hospitalization and Outcomes, March 2020 to February 2021. In this cross-sectional analysis, American Indian or Alaska Native, Latino, Black, and Asian or Pacific Islander persons were more likely than White persons to have a COVID-19–associated hospitalization, ICU admission, or in-hospital death during the first year of the US COVID-19 pandemic
Summary
The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected racial and ethnic minority populations in the United States, who are at an increased risk of infection, hospitalization, and death.[1,2] During the first 4 months of the pandemic, data from the US Centers for Disease Control and Prevention (CDC) COVID-19–Associated Hospitalization Surveillance Network (COVID-NET)[3,4,5] and other studies demonstrated that non-Hispanic Black persons were disproportionately hospitalized with COVID-19 and that racial and ethnic minority populations, including non-Hispanic Black and Hispanic or Latino persons, had higher rates of hospitalization compared with non-Hispanic White persons.[6,7,8] data on severe COVID-19 illness among other racial and ethnic minority groups, especially non-Hispanic American Indian or Alaska Native and non-Hispanic Asian or Pacific Islander populations, and longitudinal data across all racial and ethnic groups are limited. Using data from COVID-NET, a large, geographically diverse surveillance network for COVID19–associated hospitalizations, we describe rates of hospitalization, intensive care unit (ICU) admission, and in-hospital death by race and ethnicity during the first year of the pandemic
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