Association of race/ethnicity and socioeconomic status with COVID-19 30-day mortality at a Philadelphia medical center using a retrospective cohort study.
Dianna R Cheney-PetersCrystal Y LeeShuji MitsuhashiDina S ZaretJoshua M RileyChantel M VenkataramanJoseph W SchaeferBrandon J GeorgeChris J LiChrista M SmaltzConor G BradleyDanielle M FitzpatrickDavid B NeyDivya M ChalikondaJoshua D MairoseKashyap ChauhanMargaret V SzotRobert B JonesRukaiya Bashir-HamiduAlan A KubeyPublished in: Journal of medical virology (2021)
COVID-19 has disproportionately affected low-income communities and people of color. Previous studies demonstrated that race/ethnicity and socioeconomic status (SES) are not independently correlated with COVID-19 mortality. The purpose of our study is to determine the effect of race/ethnicity and SES on COVID-19 30-day mortality in a diverse, Philadelphian population. This is a retrospective cohort study in a single-center tertiary care hospital in Philadelphia, PA. The study includes adult patients hospitalized with polymerase-chain-reaction-confirmed COVID-19 between March 1, 2020 and June 6, 2020. The primary outcome was a composite of COVID-19 death or hospice discharge within 30 days of discharge. The secondary outcome was intensive care unit (ICU) admission. The study included 426 patients: 16.7% died, 3.3% were discharged to hospice, and 20.0% were admitted to the ICU. Using multivariable analysis, race/ethnicity was not associated with the primary nor secondary outcome. In Model 4, age greater than 75 (odds ratio [OR]: 11.01; 95% confidence interval [CI]: 1.96-61.97) and renal disease (OR: 2.78; 95% CI: 1.31-5.90) were associated with higher odds of the composite primary outcome. Living in a "very-low-income area" (OR: 0.29; 95% CI: 0.12-0.71) and body mass index (BMI) 30-35 (OR: 0.24; 95% CI: 0.08-0.69) were associated with lower odds of the primary outcome. When controlling for demographics, SES, and comorbidities, race/ethnicity was not independently associated with the composite primary outcome. Very-low SES, as extrapolated from census-tract-level income data, was associated with lower odds of the composite primary outcome.
Keyphrases
- coronavirus disease
- sars cov
- intensive care unit
- body mass index
- acute lymphoblastic leukemia
- end stage renal disease
- emergency department
- healthcare
- type diabetes
- physical activity
- chronic kidney disease
- cardiovascular disease
- mechanical ventilation
- electronic health record
- newly diagnosed
- ejection fraction
- coronary artery disease
- mental health
- weight gain
- peritoneal dialysis
- artificial intelligence
- weight loss
- prognostic factors
- big data
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- data analysis