Robust Testing in Outpatient Settings to Explore COVID-19 Epidemiology: Disparities in Race/Ethnicity and Age, Salt Lake County, Utah, 2020

Abstract

Objective: US-based descriptions of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have focused on patients with severe disease. Our objective was to describe characteristics of a predominantly outpatient population tested for SARS-CoV-2 in an area receiving comprehensive testing.

Methods: We extracted data on demographic characteristics and clinical data for all patients (91% outpatient) tested for SARS-CoV-2 at University of Utah Health clinics in Salt Lake County, Utah, from March 10 through April 24, 2020. We manually extracted data on symptoms and exposures from a subset of patients, and we calculated the adjusted odds of receiving a positive test result by demographic characteristics and clinical risk factors.

Results: Of 17 662 people tested, 1006 (5.7%) received a positive test result for SARS-CoV-2. Hispanic/Latinx people were twice as likely as non-Hispanic White people to receive a positive test result (adjusted odds ratio [aOR] = 2.0; 95% CI, 1.3-3.1), although the severity at presentation did not explain this discrepancy. Young people aged 0-19 years had the lowest rates of receiving a positive test result for SARS-CoV-2 (<4 cases per 10 000 population), and adults aged 70-79 and 40-49 had the highest rates of hospitalization per 100 000 population among people who received a positive test result (16 and 11, respectively).

Conclusions: We found disparities by race/ethnicity and age in access to testing and in receiving a positive test result among outpatients tested for SARS-CoV-2. Further research and public health outreach on addressing racial/ethnic and age disparities will be needed to effectively combat the coronavirus disease 2019 pandemic in the United States.

Keywords: COVID-19; SARS-CoV-2; comprehensive testing; health disparities; outpatient.

Figure 1

Racial/ethnic distribution of people who tested positive and were hospitalized for SARS-CoV-2, by department ordering the test, from March 10 through April 24, 2020, University of Utah Health, Salt Lake City, Utah. (A) The percentage of people by each race from the 2019 census estimates for Salt Lake County, the proportion of people tested by race/ethnicity, the proportion of people who tested positive by race/ethnicity, and the proportion of people who were hospitalized within 14 days of a positive test result by race/ethnicity. (B) The proportion of tests ordered from each hospital department by race/ethnicity. Proportion of hospitalized is among people who received a positive test result for SARS-CoV-2. Abbreviation: SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.

Figure 2

Age distribution of people who were tested and hospitalized for SARS-CoV-2 from March 10 through April 24, 2020, at University of Utah Health, Salt Lake City, Utah, by people who had (A) a positive test result or (B) a negative test result for SARS-CoV-2. Abbreviation: SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.