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Racial/ethnic disparities in COVID-19 disease burden & mortality among emergency department patients in a safety net

Nana-Yaa Misa1, Berenice Perez1, Kellie Basham1

  • 1Department of Emergency Medicine, Alameda Health System, United States of America.

The American Journal of Emergency Medicine
|October 11, 2020
PubMed

Insights

Latinx patients had higher COVID-19 test positivity, while Black patients experienced greater mortality. Emergency department data reveals significant racial and ethnic disparities in COVID-19 outcomes.

Area of Science:

  • Public Health
  • Epidemiology
  • Infectious Diseases

Background:

  • Examined racial and ethnic disparities in COVID-19 testing and outcomes.
  • Focused on emergency department (ED) patients within a Northern California public health system.

Purpose of the Study:

  • To investigate disparities in COVID-19 test positivity rates and mortality.
  • To analyze outcomes among diverse racial and ethnic groups in an integrated health system.

Main Methods:

  • Retrospective analysis of ED patients tested for COVID-19 (April 6 - May 4, 2020).
  • Primary outcome: test positivity rate by race/ethnicity.
  • Secondary outcome: 30-day in-hospital mortality.
  • Multivariable logistic regression used to assess COVID-19 test positivity associations.

Main Results:

  • 18.1% of 526 tested patients were COVID-19 positive.
  • Latinx patients had a 40.3% positivity rate vs. 10.1% for non-Latinx (p < 0.001).
  • Latinx ethnicity significantly associated with COVID-19 positivity (aOR 9.6).
  • Black patients showed higher mortality (18.7%) than non-Black patients (1.3%, p < 0.001).

Conclusions:

  • Significant disparities in COVID-19 test positivity (Latinx) and mortality (Black patients) were observed.
  • ED-based testing data can identify and quantify racial/ethnic disparities in COVID-19.
  • Findings can inform public health policy to address health inequities.
Abstract

Keywords:
COVID-19Emergency departmentHealth disparitiesPublic health

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