COVID-19 health inequities and association with mechanical ventilation and prolonged length of stay at an urban safety-net health system in Chicago

PLoS One. 2021 Oct 13;16(10):e0258243. doi: 10.1371/journal.pone.0258243. eCollection 2021.

Abstract

Millions of Americans have been infected with COVID-19 and communities of color have been disproportionately burdened. We investigated the relationship between demographic characteristics and COVID-19 positivity, and comorbidities and severe COVID-19 illness (use of mechanical ventilation and length of stay) within a racial/ethnic minority population. Patients tested for COVID-19 between March 2020 and January 2021 (N = 14171) were 49.9% (n = 7072) female; 50.1% (n = 7104) non-Hispanic Black; 33.2% (n = 4698) Hispanic; and 23.6% (n = 3348) aged 65+. Overall COVID-19 positivity was 16.1% (n = 2286). Compared to females, males were 1.1 times more likely to test positive (p = 0.014). Compared to non-Hispanic Whites, non-Hispanic Black and Hispanic persons were 1.4 (p = 0.003) and 2.4 (p<0.001) times more likely, respectively, to test positive. Compared to persons ages 18-24, the odds of testing positive were statistically significantly higher for every age group except 25-34, and those aged 65+ were 2.8 times more likely to test positive (p<0.001). Adjusted for race, sex, and age, COVID-positive patients with chronic obstructive pulmonary disease were 1.9 times more likely to require a ventilator compared to those without chronic obstructive pulmonary disease (p = 0.001). Length of stay was not statistically significantly associated with any of the comorbidity variables. Our findings emphasize the importance of documenting COVID-19 disparities in marginalized populations.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • COVID-19 / ethnology
  • COVID-19 / pathology*
  • COVID-19 / virology
  • Chicago
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Health Status Disparities*
  • Humans
  • Length of Stay*
  • Male
  • Middle Aged
  • Respiration, Artificial*
  • SARS-CoV-2 / isolation & purification
  • Young Adult

Grants and funding

The authors received no specific funding for this work.