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Published on: April 9, 2021
Coronavirus disease 19 in minority populations of Newark, New Jersey
Alexis K Okoh1, Christoph Sossou2, Neha S Dangayach2
1Heart and Lung Research Center, RWJ Barnabas Health, Newark Beth Israel Medical Center, 201 Lyons, Avenue, Suite G5., Newark, New Jersey, 07112, USA. alexis.okoh@rwjbh.org.
Insights
Black/African American and Latino patients with COVID-19 faced high in-hospital mortality and morbidity. Older age and elevated inflammatory markers were key predictors of death in this underserved population.
Area of Science:
- Medical research
- Public health
- Epidemiology
Background:
- COVID-19 disproportionately affects minority populations.
- Understanding clinical features and outcomes in Black/African American (AA) and Latino Hispanic patients is crucial.
- An inter-city hospital in New Jersey provides a relevant setting for this study.
Purpose of the Study:
- To report the clinical features and outcomes of Black/African American (AA) and Latino Hispanic patients hospitalized with COVID-19.
- To analyze demographic, socioeconomic, and clinical data.
- To identify predictors of in-hospital mortality.
Main Methods:
- Retrospective cohort study of AA and Latino Hispanic patients with COVID-19.
- Data collected from a 665-bed teaching hospital in Newark, New Jersey.
- Logistic regression analysis to determine predictors of in-hospital death.
Main Results:
- High incidence of in-hospital mortality (38.6%) and morbidity, including septic shock (24%), AKI requiring hemodialysis (21%), and ICU admission (33%).
- Common symptoms included dyspnea (39%), cough (38%), and fever (34%).
- Patients were from areas with high population density and low median income.
Conclusions:
- Over one-third of underserved minority patients experienced in-hospital death or morbidity.
- Older age, lower hemoglobin, and elevated inflammatory markers (Ferritin, Creatinine phosphokinase) were independent predictors of in-hospital mortality.
- Findings highlight the vulnerability of minority populations to severe COVID-19 outcomes.
Background:
The purpose of this study is to report the clinical features and outcomes of Black/African American (AA) and Latino Hispanic patients with Coronavirus disease 2019 (COVID-19) hospitalized in an inter-city hospital in the state of New Jersey.
Methods:
This is a retrospective cohort study of AA and Latino Hispanic patients with COVID-19 admitted to a 665-bed quaternary care, teaching hospital located in Newark, New Jersey. The study included patients who had completed hospitalization between March 10, 2020, and April 10, 2020. We reviewed demographics, socioeconomic variables and incidence of in-hospital mortality and morbidity. Logistic regression was used to identify predictor of in-hospital death.
Results:
Out of 416 patients, 251 (60%) had completed hospitalization as of April 10, 2020. The incidence of In-hospital mortality was 38.6% (n = 97). Most common symptoms at initial presentation were dyspnea 39% (n = 162) followed by cough 38%(n = 156) and fever 34% (n = 143). Patients were in the highest quartile for population's density, number of housing units and disproportionately fell into the lowest median income quartile for the state of New Jersey. The incidence of septic shock, acute kidney injury (AKI) requiring hemodialysis and admission to an intensive care unit (ICU) was 24% (n = 59), 21% (n = 52), 33% (n = 82) respectively. Independent predictors of in-hospital mortality were older age, lower serum Hemoglobin < 10 mg/dl, elevated serum Ferritin and Creatinine phosphokinase levels > 1200 U/L and > 1000 U/L.
Conclusions:
Findings from an inter-city hospital's experience with COVID-19 among underserved minority populations showed that, more than one of every three patients were at risk for in-hospital death or morbidity. Older age and elevated inflammatory markers at presentation were associated with in-hospital death.
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