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African Americans Possessed High Prevalence of Comorbidities and Frequent Abdominal Symptoms, and Comprised A Disproportionate Share of Covid-19 Mortality among 9,873 Us- Hospitalized Patients Early in the Pandemic.
Ashktorab, Hassan; Pizuorno, Antonio; Chirumamilla, Lakshmi Gayathri; Adeleye, Folake; Dalivand, Maryam Mehdipour; Sherif, Zaki A; Oskrochi, Gholamreza; Challa, Suryanarayana Reddy; Jones-Wonni, Boubini; Rankine, Sheldon; Ekwunazu, Chiamaka; Banson, Abigail; Kim, Rachel; Gilliard, Chandler; Ekpe, Elizabeth; Shayegh, Nader; Nyaunu, Constance; Martins, Chidi; Slack, Ashley; Okwesili, Princess; Abebe, Malachi; Batta, Yashvardhan; Ly, Do; Valarie, Ogwo; Smith, Tori; Watson, Kyra; Kolawole, Oluwapelumi; Tahmazian, Sarine; Atoba, Sofiat; Khushbakht, Myra; Riley, Gregory; Gavin, Warren; Kara, Areeba; Hache-Marliere, Manuel; Palaiodimos, Leonidas; Mani, Vishnu R; Kalabin, Aleksandr; Gayam, Vijay Reddy; Garlapati, Pavani Reddy; Miller, Joseph; Jackson, Fatimah; Carethers, John M; Rustgi, Vinod; Brim, Hassan.
Afiliación
  • Ashktorab H; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Pizuorno A; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Chirumamilla LG; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Adeleye F; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Dalivand MM; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Sherif ZA; Department of Pathology and Cancer Center, Department of Biochemistry & Molecular Biology, Howard University College of Medicine, Washington DC, USA.
  • Oskrochi G; College of Engineering and Technology, American University of the Middle East, Kuwait.
  • Challa SR; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Jones-Wonni B; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Rankine S; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Ekwunazu C; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Banson A; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Kim R; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Gilliard C; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Ekpe E; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Shayegh N; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Nyaunu C; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Martins C; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Slack A; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Okwesili P; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Abebe M; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Batta Y; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Ly D; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Valarie O; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Smith T; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Watson K; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Kolawole O; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Tahmazian S; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Atoba S; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Khushbakht M; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Riley G; Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA.
  • Gavin W; Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, IN, USA.
  • Kara A; Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, IN, USA.
  • Hache-Marliere M; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
  • Palaiodimos L; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
  • Mani VR; Department of Trauma, Acute and Critical Care Surgery, Duke University Medical Center, NC, USA.
  • Kalabin A; Department of Surgery, Columbia University College of Physicians and Surgeons at Harlem Hospital, NY, USA.
  • Gayam VR; Department of Medicine, Interfaith Medical Center, NY, USA.
  • Garlapati PR; Department of Medicine, Interfaith Medical Center, NY, USA.
  • Miller J; Departments of Emergency Medicine and Internal Medicine, Henry Ford Hospital, Detroit, MI, USA.
  • Jackson F; Department of Pathology and Cancer Center, Department of Biochemistry & Molecular Biology, Howard University College of Medicine, Washington DC, USA.
  • Carethers JM; Division of Gastroenterology and Hepatology, Department of Internal Medicine; Department of Human Genetics and Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA.
  • Rustgi V; Division of Gastroenterology and Hepatology, Robert Wood Johnson University Hospital - New Brunswick, NJ.
  • Brim H; Department of Pathology and Cancer Center, Department of Biochemistry & Molecular Biology, Howard University College of Medicine, Washington DC, USA.
Arch Intern Med Res ; 7(1): 27-41, 2024.
Article en En | MEDLINE | ID: mdl-38694760
ABSTRACT
Background and

aim:

Identifying clinical characteristics and outcomes of different ethnicities in the US may inform treatment for hospitalized COVID-19 patients. Aim of this study is to identify predictors of mortality among US races/ethnicities. Design Setting and

participants:

We retrospectively analyzed de-identified data from 9,873 COVID-19 patients who were hospitalized at 15 US hospital centers in 11 states (March 2020-November 2020). Main Outcomes and

Measures:

The primary outcome was to identify predictors of mortality in hospitalized COVID-19 patients.

Results:

Among the 9,873 patients, there were 64.1% African Americans (AA), 19.8% Caucasians, 10.4% Hispanics, and 5.7% Asians, with 50.7% female. Males showed higher in-hospital mortality (20.9% vs. 15.3%, p=0.001). Non- survivors were significantly older (67 vs. 61 years) than survivors. Patients in New York had the highest in-hospital mortality (OR=3.54 (3.03 - 4.14)). AA patients possessed higher prevalence of comorbidities, had longer hospital stay, higher ICU admission rates, increased requirement for mechanical ventilation and higher in-hospital mortality compared to other races/ethnicities. Gastrointestinal symptoms (GI), particularly diarrhea, were more common among minority patients. Among GI symptoms and laboratory findings, abdominal pain (5.3%, p=0.03), elevated AST (n=2653, 50.2%, p=<0.001, OR=2.18), bilirubin (n=577, 12.9%, p=0.01) and low albumin levels (n=361, 19.1%, p=0.03) were associated with mortality. Multivariate analysis (adjusted for age, sex, race, geographic location) indicates that patients with asthma, COPD, cardiac disease, hypertension, diabetes mellitus, immunocompromised status, shortness of breath and cough possess higher odds of in-hospital mortality. Among laboratory parameters, patients with lymphocytopenia (OR2=2.50), lymphocytosis (OR2=1.41), and elevations of serum CRP (OR2=4.19), CPK (OR2=1.43), LDH (OR2=2.10), troponin (OR2=2.91), ferritin (OR2=1.88), AST (OR2=2.18), D-dimer (OR2=2.75) are more prone to death. Patients on glucocorticoids (OR2=1.49) and mechanical ventilation (OR2=9.78) have higher in-hospital mortality.

Conclusion:

These findings suggest that older age, male sex, AA race, and hospitalization in New York were associated with higher in-hospital mortality rates from COVID-19 in early pandemic stages. Other predictors of mortality included the presence of comorbidities, shortness of breath, cough elevated serum inflammatory markers, altered lymphocyte count, elevated AST, and low serum albumin. AA patients comprised a disproportionate share of COVID-19 death in the US during 2020 relative to other races/ethnicities.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Arch Intern Med Res Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Arch Intern Med Res Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos