Profound racial disparities in COVID-19 associated hospitalizations in rural Southwest Georgia

Am J Med Sci. 2022 Jul;364(1):1-6. doi: 10.1016/j.amjms.2021.10.013. Epub 2021 Nov 6.

Abstract

Background: The coronavirus disease 2019 (COVID-19) is responsible for one of the largest public health crises the United States has seen to date. This study explores the outcomes of African American and non-African American COVID-19-positive patients hospitalized in rural Southwest Georgia to identify differences in morbidity and mortality between the groups.

Methods: We performed a retrospective cohort analysis among adults aged ≥18 years admitted with COVID-19 between March 2, 2020 and June 17, 2020 at Phoebe Putney Health System. Data on demographics, comorbidities, presenting symptoms, and hospital course were obtained. Patients were divided into two groups: African Americans and non-African Americans. We examined differences in patient characteristics between groups using chi-square tests for categorical variables, t-test for parametric continuous variables, and Wilcoxon rank-sum tests for non-parametric continuous variables. Statistical Analysis Software (SAS) version 9.4 was used for statistical analysis.

Results: Among 710 patients, median age was 63 years, 43.8% were males, and 83.3% were African Americans. African Americans had higher prevalence of obesity and hypertension, were more likely to present with fever, and present with longer duration of symptoms prior to presentation. In-hospital mortality was similar between the groups, as was need for mechanical ventilation, ICU care, and new dialysis. African Americans were more likely to be discharged home compared to non-African Americans.

Conclusions: There was no difference in in-hospital mortality; however, African Americans had disproportionately higher hospitalizations, likely to significantly increase the morbidity burden in this population. Urgent measures are needed to address this profound racial disparity.

Keywords: African American; COVID-19; Morbidity; Mortality.

MeSH terms

  • Adult
  • Black or African American*
  • COVID-19 / epidemiology
  • COVID-19 / ethnology*
  • COVID-19 / therapy
  • Cohort Studies
  • Female
  • Georgia / epidemiology
  • Healthcare Disparities
  • Hospital Mortality / ethnology
  • Hospitalization / statistics & numerical data
  • Humans
  • Hypertension / epidemiology
  • Hypertension / ethnology
  • Male
  • Middle Aged
  • Morbidity
  • Obesity / epidemiology
  • Obesity / ethnology
  • Prevalence
  • Retrospective Studies
  • Rural Population
  • Treatment Outcome
  • United States / epidemiology