Representation Of African Americans Research Articles

Subverting Representation: African Americans in Horror Film

This article explores the slowly changing representation of African Americans in horror films. Scream 2 (1997), I Am Legend (2007), and Get Out (2017) are used as case studies to illustrate what little progression has taken place through the decades in relationship to African Americans on-screen in horror cinema. Topics such as stereotypical tropes, narrative conventions, themes of dehumanization, and racial oppression are investigated across each film to highlight representational similarities and differences through time.

S844 Inpatient Outcomes and Healthcare Utilization in Obese vs Non-Obese Patients Hospitalized with an Acute Ulcerative Colitis Flare - A Nationwide Cohort Study

Introduction: Ulcerative colitis (UC) remains a leading cause of patient morbidity and in severe cases, mortality. Given the rise in prevalence of obesity in the United States, the goal of this study is to illustrate the impact of obesity in hospitalized patients admitted for acute flares of ulcerative colitis (UC). Our primary outcome was adjusted odds of inpatient mortality. Secondary outcomes included length of hospitalization (LOS), total hospital charge (THC), and complications including sepsis, upper and lower GI bleed (UGIB)(LGIB), and acute kidney injury (AKI). Methods: The National Inpatient Sample (NIS, 2016-2018) was sourced for hospitalization data from adult patients admitted for UC flares. The queried pool of patients was stratified into obese (BMI ≥ 30), and non-obese cohorts using International Classification of Diseases, Tenth Revision (ICD-10) codes. After performing descriptive analysis on the involved cohorts, linear and multivariate regression was used to evaluate study outcomes. STATA 14 was used for data analysis. Results: Of 142,094 admissions for UC flare, 12,989 (9.14%) had comorbid obesity. Compared to non-obese-UC patients, obese-UC patients were significantly older (51.2 vs 48.5 years, p < 0.0001), were more often female (63.9% vs 53.0%, p < 0.0001), had greater Caucasian and African American representation (73.0% vs 71.5%, p < 0.0001), (13.8% vs 11.3%, p < 0.0001) compared to non-obese patients. Obese-UC patients had more comorbid disease as measured by a Charlson Comorbidity Index score ≥3 (16.4% vs 9.62, p < 0.0001), and had more patients belonging to the poorest quartile of family income (27.9% vs 23.9%, p< 0.0001). Obese-UC patients as compared to those without obesity had a nonsignificant increase in adjusted odds of inpatient mortality (aOR 1.17; 95% CI 0.67-2.03, p=0.583). Obese-UC had higher rates of complications including LGIB (OR 1.79, p = 0.017), Shock (OR 1.48, p = 0.017), AKI (OR 1.42, p = 0.001). Additionally, Obese-UC patients had an increased LOS (5.48 vs 5.18 days, p = 0.007) and higher THC ($54,194 vs $49,957, p = 0.005). Conclusion: Obesity did not significantly increase inpatient mortality. However Obese-UC patients had increased complications (LGIB, Shock, AKI), LOS, and THC relative to UC patients without obesity. Additional studies are needed to further investigate the effects of obesity in UC, and to help reduce the economic burden obesity places on the healthcare system.

S894 Inpatient Outcomes and Healthcare Utilization in Obese vs Non-Obese Patients Hospitalized with an Acute Crohn’s Disease Flare—A Nationwide Cohort Study

Introduction: Crohn’s Disease (CD) remains a leading cause of patient morbidity and in severe cases, mortality. Given the rise in prevalence of obesity in the United States, the goal of this study is to illustrate the impact of obesity on hospitalized patients admitted for acute flares of Crohn’s Disease (CD). Our primary outcome was odds of inpatient mortality. Secondary outcomes included length of hospitalization (LOS), total hospital charge (THC), and complications including sepsis, upper and lower GI bleed (UGIB)(LGIB), and acute kidney injury (AKI). Methods: The National Inpatient Sample (NIS 2016-2018) was sourced for hospitalization data from adult patients admitted for a CD flare. The queried pool of patients was stratified into obese (BMI ≥ 30), and non-obese cohorts using International Classification of Diseases, Tenth Revision (ICD-10) codes. After performing descriptive analysis on the involved cohorts, linear and multivariate regression was used to evaluate study outcomes. STATA 14 was used for data analysis. Results: Of 232,650 admissions for CD flare, 20,100 (8.64%) had comorbid obesity. Compared to non-obese-CD patients, obese-CD patients were significantly older (45.8 vs 43.7 years, p < 0.0001), were more often female (65.9% vs 52.7%, p < 0.0001), and had greater African American representation (17.3% vs 15.4%, p < 0.0001) compared to non-obese patients. Obese-CD patients had more comorbid disease as measured by a Charlson Comorbidity Index score ≥3 (9.80% vs 5.16, p < 0.0001), and had more patients belonging to the poorest quartile of family income (29.0% vs 26.3%, p< 0.0001). No difference in adjusted odds of inpatient mortality was noted between the two groups. Obese-CD had higher rates of AKI (OR 1.17, p = 0.011), and had significantly increased LOS (5.04 vs 4.78 days, p = 0.006). There were no differences in total hospital cost, LGIB, or shock. Conclusion: Obesity did not significantly increase inpatient mortality. However Obese-CD patients had increased odds of AKI and increased LOS relative to CD patients without obesity. Additional studies are needed to further investigate the effects of obesity in CD, and to help reduce the economic burden obesity places on the healthcare system.

A Mini-Review of Strategies for Recruiting Older African Americans to Alzheimer's Disease Research.

African Americans experience higher incidence and prevalence of Alzheimer's disease (AD). Yet, they continue to be underrepresented in AD research, limiting the ability to generalize findings to the increasingly diverse US population. To reduce AD disparities, targeted efforts are needed to increase the representation of African Americans in AD research. This mini review identified evidence-based strategies that increased research participation among older African Americans. Four recruitment strategies emerged from eight published peer-reviewed studies that directly evaluated the effectiveness of strategies aimed at increasing the number of African American participants in Alzheimer's research. The strategies include community outreach and education, face-to-face discussions, remote access, and referral and partnership with local organizations. Across different locations, these strategies increased the number of African Americans enrolled into AD research, the number of people that signed up to donate their brains for AD research upon death, and the knowledge and perception of AD in the communities. Targeted efforts are effective in increasing AD research participation among older African Americans, especially when combined with approaches that emphasize transparency and mutual trust and involve the community as stakeholders in the research process.

Shaping the Identity through Dramatizing the Memories - A Study of August Wilson’s The Piano Lesson

There is no doubt with the claim that the African-American people have been suffering from a traumatic past of slavery and injustice long time ago. Similarly, they still suffer, but presently with another form of discrimination which is racism. The study argues that August Wilson, in particular, and the African-Americans, in general, are tremendously keen on maintaining their memories because memories do have an irreplaceable part in one’s identity. The study explores Wilson’s The Piano Lesson as a case in point. The present study aims at exploring Wilson as a prolific dramatist whose style was so vigorous and a reflection of the African-Americans’ life of. Furthermore, it sheds light on his play, The Piano Lesson, and how it plays a significant role and a powerful testimony in shaping the memories of the African-American people.The study is divided into two sections and a conclusion. The first section introduces the concept of identity, and it comes across August Wilson as a dramatist. Then it deals with the African American Theatre. On the other hand, the second section deals with The Piano Lesson and how it is viewed as a powerful testimony to the idea that the African-American people cherished their own memories since memories shape one’s identity. Eventually, the last part is the conclusion which sums up the research’s findings.

The Representation of African Americans in Donald Trump’s Presidential Messages on Juneteenth: A CDA Study The paper revised

The Representation of African Americans in Donald Trump’s Presidential Messages on Juneteenth: A CDA Study The paper revised

Say Their Names: Drama of the Black Lives Matter Era

, and Antoinette Nwandu's Pass Over--represent a new subgenre in African American theater that might be termed BLM (Black Lives Matter) Drama. Located at a crossroads between the past (especially the legacies of artists like Black Arts playwright LeRoi Jones [Amiri Baraka] and innovator Suzan-Lori Parks) and the present (in the wake of Freddie Gray, Eric Garner, Breonna Taylor, George Floyd, and many others), these works exemplify urgent political and aesthetic choices that foster activism. Among the techniques discussed in the close readings of these three works are their indictments of audience passivity, their calls to action by recording and remembrance, and their awareness of the multi-layered qualities of racial injustice.

Abstract 2210: The study of age and race genetic signatures of prostate cancer with formalin fixed paraffin embedded (FFPE) samples

Abstract Objectives: Diagnosis with prostate cancer (PCa) at younger age is a serious challenge in Military Health System. PCa onset at younger age is more likely to be aggressive in African American (AA) population. Also, application of formalin fixed paraffin embedded (FFPE) tissue in RNA based study was significantly hindered due to poor quality/quantity of RNA in archived pathology slides. This study is aimed to examine age/race associated gene signatures in military cohort with high representation of AA and younger population in FFPE samples for potential genetic mechanisms of health disparities and broaden tissue sample availability. Methods: A cohort of 41 Caucasian American (CA) and 20 AA non-familial PCa patients from the biospecimen bank of CPDR, WRNMMC were used. Specimens donated by radical prostatectomy patients who provided written consent and protocols approved by Institutional Review Boards. Total RNA was extracted from tumor and the adjacent normal epithelium of whole-mount FFPE tissue of matched specimens. Differential gene expression, in tumor versus normal tissues, between younger and older AA and CA patients were analyzed by NanoString using a customized CodeSet of 151 probes. The panel designed to detect 135 target transcripts, compiled from 34 genes implicated/associated with PCa progression, 27 PCa specific gene fusions, 25 cancer-associated genes, and 5 genes encoding ETS-family of transcription factors. The 27 over-expressed genes and 17 under-expressed genes in PCa were included as comparison to matched, benign epithelium. Additionally, 5 prostate stroma or epithelium specific genes were selected as control and 11 housekeeping genes were included for biological normalization. Results: The differentially expressed genes related to tumor-normal differences between AA older (66-73 years) and younger (42-58 years) as well as CA older and younger PCa patients with moderate Gleason score (3+3 and 3+4) sum were identified. After controlling for false discovery rates, panel of nine genes (ANXA2, C-MYC, VEGFR1, ERG, NPY, PSMA/FOLH1, TWIST1, MAOA, MYCN) uniquely associated with age/race were identified. Tumor vs normal ratios of ANXA2 and C-MYC expression in prostate tumors of older and younger patients were significantly enhanced. We found a clear association of VEGFR1 gene expression with CA young and c-MYC gene with AA young PCa. Conclusions: Using age/race as endpoint, we identified ANXA2, c-MYC and VEGFR1 as age and race associated PCa gene. Our findings highlight distinct racial and age-related differences and addresses the clinical utility of available genetic tests across old and young AA and CA men, which needs to be further validated in lager cohort. Further, our study also highlighted the utilization of FFPE tissue for NanoString assay and subsequent genetic signature analyses. Citation Format: Shashwat Sharad, Darryl Nousome, Gregory T. Chesnut, Hua Li. The study of age and race genetic signatures of prostate cancer with formalin fixed paraffin embedded (FFPE) samples [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2210.

Strategies For Responding To Inequity: A Conversation With Black Leadership

Sponsored by the Roundtable for African American Concerns (RAAC) of the South Carolina Library Association (SCLA), this session featured African American representation from various levels of Charleston County Public Library management. Each panelist discussed their experiences of racial inequity (Individual, Institutional, and Structural), finding and being advocates, coping and self-care methods, and positive outcomes. Panelists also offered strategies and solutions for handling inequity. The article discusses what was the catalyst leading to the deliberate, purposeful efforts of Charleston County Public Library to include Equity as one of the core principles in its Strategic Vision for 2021-2024.

Humor, Minstrelsy, and the Representation of African Americans in Macon's Georgia Telegraph and Georgia Citizen, 1855–1860

Humor, Minstrelsy, and the Representation of African Americans in Macon's Georgia Telegraph and Georgia Citizen, 1855–1860

Minority Representation in studies cited as references in National Comprehensive Cancer Network (NCCN) Guidelines for Prostate Cancer.

e18511 Background: Prostate cancer (PC) has a higher incidence, higher lifetime risk, higher risk of progression and lower overall 5-year survival in African American (AA) men compared to Caucasian men. Historically AA men have been under-represented in clinical studies that may prevent some AA men with PC to receive appropriate therapies. We aim to estimate the AA representation in studies cited in national guidelines for PC. Methods: We retrospectively reviewed all listed references in the National Comprehensive Cancer network (NCCN) Prostate cancer guidelines version 2.2021. All cited papers were reviewed for patient level data on racial or ethnic distribution in the study population. Subgroup analysis was performed by subheadings in the guidelines for Black/African American (AA) representation in each topic of discussion. Duplicate studies in the same section were excluded. Results: A total 836 references were screened of which 167 (20%) reported patient race/ethnicity distribution. Overall, 2,711,194 patients were included in reported studies of which 2,263,936 (83.5%) were Caucasian, 12.6% AA and 3.9% others. A total 26 studies reported 20% or more AA of which 14 were under 500 patients only. While 72 studies included over 1000 patients, only 9 of them had over 20% AA patients. Only 1 study (72 patients) out of 12 for systemic therapy in castration-naïve PC reported ethnicities. For Castration resistant PC, ethnicity data was available for 152 patients (3 of 10 studies), 771 patients (2 of 11 studies) and 1200 patients (1 of 4 studies) in abiraterone, enzalutamide and apalutamide studies respectively with 47.4%, 9.2% and 5.7% AA respectively. Olaparib, rucaparib, pembrolizumab and bisphosphonates studies reported 1.4%, 6.3%, 7% and 5.7% AA respectively. Further subgroup analysis is presented in Table. Conclusions: Race/ethnicity data is not reported widely in clinical studies. The overall AA representation remains very low which is also an underestimation since about 80% studies did not report patient ethnicities. Clinical investigators should be encouraged to report racial representation in studies which will help personalize cancer care for African Americans who are at high risk.[Table: see text]

Racial Discrimination and Alcohol Problems: Examining Interactions with Genetic Risk and Impulsivity among African American Young Adults.

Experiences of racial discrimination have been shown to increase risk for alcohol problems. Some individuals may be particularly vulnerable to the negative effects of racial discrimination. However, little research has examined interaction effects between racial discrimination and individual characteristics, such as genetic predispositions and personality, in relation to alcohol outcomes. This study examined whether genetic risk and dimensions of impulsivity moderate the association between racial discrimination and alcohol problems among African American young adults (n = 383, Mage = 20.65, SD = 2.28; 81% female). Participants completed online surveys and provided a saliva sample for genotyping. Results from multiple regression analyses indicated that both blatant and subtle forms of racial discrimination (i.e., experience of racist events and racial microaggressions) were associated with more alcohol problems. Racial microaggressions interacted with dimensions of impulsivity in relation to alcohol problems, such that racial microaggressions were associated with more alcohol problems when negative urgency was high or when sensation seeking was low. There was no significant interaction between alcohol use disorder genome-wide polygenic score and experience of racist events or racial microaggression in relation to alcohol problems, which may partly reflect low power due in part to limited representation of African-Americans in genetic research. The findings highlight the need to increase the representation of African Americans in genetically-informed research in order to better characterize genetic risk and understand gene-environment interaction in this understudied population, as well as the importance of examining impulsivity as a multidimensional construct that interacts with racial discrimination in relation to alcohol outcomes.

“There Would Be No Kerry Washington without Diahann Carroll”: Shout-Out Culture, Sisterhood, and the Discourse of Black Womanhood

This article theorizes the relevance of the shout-out, a public expression of appreciation, as an African American cultural tradition and explores how Black actresses intentionally use shout-outs in awards show speeches to acknowledge each other’s work and to collectively rearticulate ideological understandings of Black womanhood. In tracing the explicit ways that Black actresses use shout-outs, this study examines the interconnections among Black actresses in Hollywood, revealing what they say to and about each other and the larger meanings implicit in these conversations as they relate to broader issues of African American representation. Focusing specifically on Black-themed awards shows, I argue that Black actresses cultivate their own spaces and create room for themselves to celebrate and shout out each other and each other’s work, forming a sisterhood that thrives on mentorship and empowerment, thus creating a legacy and an alternative archive of Black women’s accomplishments on-screen.

Abstract PO-214: Cancer disparities and African American representation in clinical trials involving Accelerated Partial Breast Irradiation Therapy

Abstract Background Radiation therapy is a critical component in the multi-disciplinary care of many breast cancer patients, but traditionally, has necessitated daily treatment visits over several weeks. Accelerated partial breast irradiation (APBI) in appropriately selected patients affords clinical outcomes that rival those achieved with conventionally fractionated whole-breast radiation. In addition to exposing a smaller volume of breast to radiation, APBI also allows reduction in total number of radiation treatment fractions to 1-10. This regimen thus stands to particularly benefit minorities such as Black American patients, who suffer disproportionately from high rates of economic burden in the form of absence from work, lost wages, and transportation costs related to prolonged cancer treatments. Yet, Black Americans have been traditionally underrepresented in clinical trials, threatening the generalizability of new treatments like APBI. In this study, we evaluated the racial makeup of clinical trials evaluating ABPI and the inclusion of Black Americans in these studies. Methods We retrospectively reviewed all published manuscripts involving accelerated partial breast irradiation therapy and analyzed the demographics of their study populations. Studies reported from centers outside the United States were excluded. When race reporting was not available in the published results, this information, where available, was obtained through the NIH Clinical trials registry. Results A total of 130 APBI trials were identified by PubMed search. Out of these, 80 studies were based in the United States. A total of 20 studies investigating APBI provided demographics data, comprising 1735 total patients. Of these, 1488 patients were White (85.7%), 124 were Black (7.1%), 67 were Hispanic (3.9%), and 46 were Asian (2.7%), and 10 patients were classified as multiple or unknown (0.6%). This percentage is lower than the 2019 US Census estimate of 13.4% Black Americans. We compared these results to two APBI trials conducted at our institution investigating 5-fraction and single fraction APBI regimens. Out of a total of 104 patients treated, 17 patients (16.3%) were Black. The higher proportion of Black Americans in our trials is likely due to a unique partnership between Parkland Hospital, a county Hospital that serves a high proportion of minority patients, and UT Southwestern Medical Center, which provides access to technologically sophisticated treatments such as APBI. Conclusion Despite APBI being uniquely positioned to provide increased benefits to racial minorities, Black Americans are underrepresented in clinical trials evaluating APBI, mirroring the broader national trend in all clinical trials. Based on our institutional experience, partnership between academic medical centers, which often have access to novel treatment regimens and county hospitals, which serve a large proportion of minority patients, is needed to reduce racial disparities in clinical trial participation and to eventually narrow and eliminate the racial health disparity gap. Citation Format: Ev Kakadiaris, Brian K Lue, Sherry Gu, Jonathan C. Tyes, Prasanna Alluri. Cancer disparities and African American representation in clinical trials involving Accelerated Partial Breast Irradiation Therapy [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-214.

Representation and Preparation Matters

This interview provides insight into the lack of representation for educators of color in schools across America and explicates the importance of having education programs that are designed to develop culturally intelligent educators. The purpose of this piece is to enlighten, empower, and encourage educational entities and communities to address the gap in representation of African American and Latinx educators and educator preparation programs directly and collaboratively—not only to increase representation within the education profession but to create and implement mechanisms that will retain educators of color in the profession over the long term. The principle of ongoing professional learning typically involves educators seeking and receiving training and learning from education experts. LaTisha Cole argues that educators should instead seek authentic learning opportunities from the students and families they serve.

BMI across the lifespan and midlife cognitive function: The Bogalusa Heart Study

AbstractBackgroundGreater adiposity in middle age or earlier has been associated with both poorer and greater cognitive functioning late in life, as well as greater and poorer risk of AD (Buchman et al., 2005; Cournot et al., 2006; Sturman et al., 2008), but prior studies were primarily conducted on populations with low African American representation and have scarce data with adolescent BMI. Therefore, this investigation examined the association between adiposity from early life to mid‐life and mid‐life cognition in a bi‐racial, semi‐rural Deep Southern epidemiological cohort.MethodThe Bogalusa Heart Study has followed participants from childhood to adulthood since 1973. Adiposity (i.e., BMI), was collected at roughly biannual visits from 1973 to today and cognitive measures were collected between 2013‐2016. Cognitive measures (n = 1295) included memory, executive function (EF), and global cognition. BMI was averaged within specific age epochs (&lt;20 (adolescent), 21‐40 (early adulthood) and &gt;40 (adulthood). BMI within adolescence was converted into percentiles (Kuczmarski et al., 2002). Separate linear regression models were run with BMI, sex, race, and education as predictors, and each cognitive measure as outcomes.ResultGreater BMI within the adolescent and early‐adulthood epochs was associated with greater memory performance (Average Est. 0.006, p ≤ 0.045). None of the BMI measures in any epoch were associated with global cognition or EF.ConclusionAlthough a large body of evidence has shown that greater adiposity is associated with a wide variety of adverse health outcomes, in this study greater adiposity in adolescence and young adulthood was associated with better memory performance in mid‐life. Although paradoxical, these results are aligned with several prior studies of similar longitudinal design and racial composition. Higher‐fidelity measurement of adiposity (e.g., subcutaneous vs. visceral fat) could help clarify the complex relationship between adiposity and cognitive function.

An Empirical Examination of Representational Equity in Consolidated Governments, 1965–2002

Research on the impacts of city–county consolidation often focuses on issues relating to efficiency, effectiveness, and economic development; yet, relatively few studies have addressed the issue of racial and ethnic minority representation. Although existing research is limited, findings indicate that consolidating city and county governments dilutes minority voting strength and has a disparate impact on minority representation. However, it is not clear if this is a nationwide trend, particularly in preclearance states previously covered by the Voting Rights Act. Thus, the question becomes, does consolidation negatively affect minority representation, and to what extent? This study employs a quasi-experimental interrupted time-series analysis to ascertain the overall impact of consolidation on the descriptive representation of African Americans since 1965. Results indicate that while descriptive representation has generally increased in recent decades, there are discernible declines following consolidation and noticeable representational disparities in counties previously covered by the Voting Rights Act.

Addressing a lack of African American representation in biomedical research: Jackson State University Jackson Heart Study Graduate Training and Education Center

Addressing a lack of African American representation in biomedical research: Jackson State University Jackson Heart Study Graduate Training and Education Center

Diversifying the economics profession: the long road to overcoming discrimination and sub-representation of Hispanics and African Americans. An analysis of the United States between 1995-2019.

This paper analyses the dynamics related to the representation of African Americans and Hispanics in every level of economics within U.S. post-secondary institutions from 1995 to 2019. I show that there is underrepresentation of Hispanics and African Americans in economics and evaluate some of the possible reasons for the persistence of socioeconomic barriers, including discrimination and attitudes of self-isolation, which block minorities from advancing in academia and professional areas. I discuss some of the advances in economics that address the discrimination problem and some models that try to explain its existence. I present ways in which each member of the economics community could help to alleviate the underrepresentation of minorities in the field and relate some of the posible effects of this problem to non-U.S. institutions that teach economics. Finally, I discuss why addressing underrepresentation and discrimination in economics is important.

Altered mental status predicts length of stay but not death in a community-based cohort of hospitalized COVID-19 patients

IntroductionAltered Mental Status (AMS) is a common neurological complication in patients hospitalized with the diagnosis of COVID-19 (Umapathi et al., 2020; Liotta et al., 2020). Studies show that AMS is associated with death and prolonged hospital stay. In addition to respiratory insufficiency, COVID-19 causes multi-organ failure and multiple metabolic derangements, which can cause AMS, and the multi-system involvement could account for the prolonged hospital stay and increased mortality. In this study, we built on our previous publication (Chachkhiani et al., 2020) using a new, larger cohort to investigate whether we could reproduce our previous findings while addressing some of the prior study’s limitations. Most notably, we sought to determine whether AMS still predicted prolonged hospital stay and increased mortality after controlling for systemic complications such as sepsis, liver failure, kidney failure, and electrolyte abnormalities. ObjectivesThe primary purpose was to document the frequency of AMS in patients with COVID-19 at the time of presentation to the emergency room. Secondary aims were to determine: 1) if AMS at presentation was associated with worse outcomes as measured by prolonged hospitalization and death; and 2) if AMS remained a predictor of worse outcome after adjusting for concomitant organ failure and metabolic derangements. ResultsOut of 367 patients, 95 (26%) had AMS as a main or one of the presenting symptoms. Our sample has a higher representation of African Americans (53%) than the US average and a high frequency of comorbidities, such as obesity (average BMI 29.1), hypertension (53%), and diabetes (30%). Similar to our previous report, AMS was the most frequent neurological chief complaint. At their admission, out of 95 patients with AMS, 83 (88%) had organ failure or one of the systemic problems that could have caused AMS. However, a similar proportion (86%) of patients without AMS had one or more of these same problems. Age, race, and ethnicity were the main demographic predictors. African Americans had shorter hospital stay [HR1.3(1.0,1.7),p = 0.02] than Caucasians. Hispanics also had shorter hospital stay than non-Hispanics [HR1.6(1.2,2.1), p = 0.001]. Hypoxia, liver failure, hypernatremia, and kidney failure were also predictors of prolonged hospital stay. In the multivariate model, hypoxia, liver failure, and acute kidney injury were the remaining predictors of longer hospital stay, as well as people with AMS at baseline [HR0.7(0.6,0.9), p < 0.02] after adjusting for the demographic characteristics and clinical predictors. AMS at baseline predicted death, but not after adjusting for demographics and clinical variables in the multivariate model. Hypoxia and hyperglycemia at baseline were the strongest predictors of death. ConclusionAltered mental status is an independent predictor of prolonged hospital stay, but not death. Further studies are needed to evaluate the causes of AMS in patients with COVID-19.