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

Public Health Rep. 2021 May;136(3):345-353. doi: 10.1177/0033354920988612. Epub 2021 Feb 4.

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • COVID-19 / diagnosis*
  • COVID-19 / epidemiology*
  • COVID-19 Testing / statistics & numerical data*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Ethnicity
  • Female
  • Health Status Disparities*
  • Hospitalization / statistics & numerical data
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Outpatients / statistics & numerical data*
  • Race Factors
  • Registries
  • SARS-CoV-2
  • Utah / epidemiology
  • Young Adult