Variations in Presentation and Management of COVID-19 Inpatients by Race and Ethnicity in a Large Texas Metroplex

Area of Science:

• Public Health
• Epidemiology
• Health Disparities

Background:

• Coronavirus disease 2019 (COVID-19) has presented significant public health challenges globally.
• Understanding variations in disease presentation and outcomes across different demographic groups is crucial for effective healthcare strategies.

Purpose of the Study:

• To investigate disparities in the presentation and outcomes of COVID-19 among various racial and ethnic groups.
• To analyze intensive care unit (ICU) admission and case fatality rates in relation to race/ethnicity.
• To identify factors influencing COVID-19 hospital admission trends over the pandemic timeline.

Main Methods:

• A retrospective cohort study design was employed.
• Data were collected from patients at a large hospital in a Texas metroplex.
• Statistical analyses were performed to assess the significance of race/ethnicity and language on clinical outcomes.

Main Results:

• While socioeconomic disparities were noted, race/ethnicity was not a significant predictor of ICU admission or case fatality.
• Hospital admission rates varied by month, with earlier peaks observed among Black/African-American and Hispanic/Latino populations.
• Patients whose primary language was Spanish exhibited a significantly higher likelihood of ICU admission (OR, 1.75; P = 0.007).

Conclusions:

• COVID-19 case fatality did not show significant racial/ethnic disparities, suggesting that broader mortality disparities may stem from infection risk rather than hospital care.
• Observed variations in admission rates by race/ethnicity over time and increased ICU admissions for Spanish-speaking patients highlight the need for targeted interventions.
• Addressing health disparities requires both community-level and structural interventions to improve equitable care during and after the pandemic.