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. 2021 Oct;8(5):1161-1167.
doi: 10.1007/s40615-020-00872-x. Epub 2020 Sep 18.

Racial Disparities in COVID-19 Hospitalization and In-hospital Mortality at the Height of the New York City Pandemic

Benjamin D Renelus  1 , Neil C Khoury  2 , Karthik Chandrasekaran  2 , Ezana Bekele  2 , William M Briggs  3 , Alexander Ivanov  4 , Smruti R Mohanty  5 , Daniel S Jamorabo  6
Affiliations

Racial Disparities in COVID-19 Hospitalization and In-hospital Mortality at the Height of the New York City Pandemic

Benjamin D Renelus et al. J Racial Ethn Health Disparities. 2021 Oct.

Abstract

Objectives: Investigate whether or not race is associated with differences in hospitalization and survival to discharge among patients with coronavirus disease-2019 (COVID-19) at the height of the pandemic in New York City (NYC).

Methods: Single-center retrospective cohort study of COVID-19 patients hospitalized at our university-affiliated NYC hospital from 3/10/20 through 4/13/20 with follow-up to 5/1/20. Our primary endpoint was hospitalization rate among patients with confirmed COVID-19 compared with the regional population based on race. Our secondary endpoint survival to discharge among hospitalized COVID-19 patients. NYC Department of Health data were used to calculate hospitalization odds ratios. Chi-square and t tests were used to compare categorial and continuous variables, respectively. Cox proportional hazards regression and predictive analysis were used to investigate our endpoints further.

Results: Our cohort of 734 patients included 355 women (48.4%), 372 Blacks (50.7%), 214 Whites (29.2%), and 92 Hispanics (12.5%) in our analysis. Blacks were nearly twice as likely as Whites to require hospitalization for COVID-19 (OR 1.89, 95% CI, 1.59-2.24, p < 0.001). Hispanics were also more likely to suffer in-hospital mortality from COVID-19 compared with Whites (HR 1.84; 95% CI 1.21-2.80; p = 0.005). There was a non-significant increased hazard of in-hospital mortality among Blacks when compared with Whites (HR, 1.30; 95% CI, 0.95-1.78; p = 0.09).

Conclusions and relevance: Blacks were more likely than Whites to require hospitalization for COVID-19 while Hispanics were more likely to experience in-hospital mortality. Further investigation into the socioeconomic factors underlying racial disparities in COVID-19 survival and severity requiring hospitalization is needed on a national scale.

Keywords: Coronavirus disease-2019; Infectious disease; Racial disparities; Sex disparities.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Predictive probability of survival to discharge by age and sex
Fig. 2
Fig. 2
Kaplan-Meier plot of hospitalization survival by age and documented race
Fig. 3
Fig. 3
Predictive probability of survival to discharge by age and documented race
See this image and copyright information in PMC

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