Blacks, Hispanics Had Higher Rates of Hospitalization, Mortality from COVID-19

According to new data from the American Heart Association’s COVID-19 Cardiovascular Disease Registry, Black and Hispanic patients accounted for more than half of hospitalizations and deaths due to COVID-19.

James A. De Lemos, MD, professor of internal medicine in the division of cardiology at UT Southwestern Medical Center, presented these updates at a news briefing at the AHA Scientific Sessions 2020.

“Interventions aimed at reduce disparities will have to focus upstream from hospitalization,” Dr. De Lemos said.

The study looked at 7,868 patients hospitalized across 88 registry sites from January 1 to July 22, 2020. Among hospitalized patients, 33.0% were Hispanic, 25.5% were non-Hispanic Black, 6.3% were Asian and 35.2% were non-Hispanic white. The researchers compared the patients enrolled in the AHA COVID-19 CVD registry with population data from local census data.  The study showed that Black and Hispanic patients accounted for more than half (~58%) of hospitalizations, a much higher proportion than in the communities where the hospitalization occurred.

Hispanic patients were, on average, 12 years younger and Black patients were 9 years younger than white patients. The median age of patients hospitalized with COVID-19 was 69 years for non-Hispanic whites compared with only 60 years for Black patients and 57 years for Hispanic patients. Additionally, the probability of being uninsured or self-paying was significantly higher in Black (4.5%) or Hispanic (12.8%) patients compared with non-Hispanic white patients (2.5%).

Obesity (49.3%), diabetes (45.2%) and hypertension (69.9%) were also most common among Black patients hospitalized with COVID-19 compared with non-Hispanic white patients (36.4%, 30.5%, 63.0%, respectively) and Hispanic patients (37.8%, 37.4%, 50.0%).

Remdesivir was used slightly less frequently in Black patients than other groups (6.1% vs. 8.0% for non-Hispanic whites and 9.5% for Hispanic and 9.2% for Asian Pacific Islander patients). Black patients were more likely to require a ventilator or kidney dialysis.

After multivariable adjustment there were no differences by race or ethnic group  for in-hospital mortality or in the probability of major adverse cardiovascular events. A modified disease severity scale showed slightly higher disease severity in Asian Pacific Islanders, but there was no difference in Black or Hispanic patients.  Fifty-three percent of deaths that occurred in hospitalized patients with COVID-19 occurred in Black and Hispanic patients.

“The results highlight the disproportionate burden of COVID-19 especially among Black and Hispanic communities and imply there are factors in the U.S. that existed prior to a coronavirus diagnosis that are driving these disparities,” said the study’s lead author Fatima Rodriguez, MD, MPH, an assistant professor in cardiovascular medicine at Stanford University Medical Center in Palo Alto, California.