Study indicates COVID-19 Hospital death rates similar between blacks and whites

Study finds no race difference in COVID-19 hospital deaths When underlying medical and other risk conditions are factored out, death rates are similar between blacks and whites. CIDRAP

After adjusting for sociodemographic factors and underlying conditions, black COVID-19 patients were no more likely than white patients to die of any cause in hospitals, a retrospective study published today in JAMA Network Open has found.

Researchers at Ascension Health in St. Louis analyzed data from 11,210 adults with COVID-19 in 92 hospitals in 12 states from Feb 19 to May 31.

The death rate from any cause was 23.1% in white patients and 19.2% in black patients. After adjusting for age, sex, insurance, underlying conditions, neighborhood deprivation, and site of care, the risk of death was not significantly different between blacks and whites (hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.80 to 1.09).

Compared with whites, blacks had higher rates of asthma (8.8% vs 4.7%), cancer (3.6% vs 3.2%), chronic kidney disease (20.5% vs 12.9%), congestive heart failure (12.5% vs 10.8%), diabetes (32.0% vs 23%), high blood pressure (30.3% vs 25.0%), obesity (32.2% vs 18.2%), and organ transplantation (0.5% vs 0.3%).

Compared with hospitalized whites, black patients were more likely to have been admitted to the hospital with a fever of 38°C (100.4°F) or higher (32.1% vs 22.1%) and a respiratory rate of at least 24 breaths per minute (34.1% vs 29.6%), while they were less likely to have an oxygen saturation less than 94% (34.9% vs 40.9%). ...

Hospitals included in the study were located in Alabama (6 hospitals), Florida (5), Illinois (8), Indiana (14), Kansas (4), Maryland (1), Michigan (13), New York (2), Oklahoma (6), Tennessee (4), Texas (11), and Wisconsin (18). ...

While current reports suggest that blacks shoulder a disproportionate burden of COVID-19 infections and deaths (21% vs 13%), the authors noted that local, state, and territorial reports to the Centers for Disease Control and Prevention are missing about 55% of race data.

They said that living conditions, workplace differences, and underlying medical conditions may help explain why ethnic minorities appear to bear a disproportionate burden of COVID-19 illness and death overall. But their findings, they added, confirm those of previous studies in Louisiana and Georgia that found no difference in death rates by race in hospitalized COVID-19 patients.

"Taken together, these findings suggest that while Black US residents may be at higher risk of contracting COVID-19 and represent a disproportionate share of COVID-19 death, mortality for those able to access hospital care does not differ from White patients," the authors wrote. ...