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Publication
Differences in Inflammation, Treatment, and Outcomes Between Black and Non-Black
Patients Hospitalized for COVID-19: A Prospective Cohort Study.
Authors Azam TU, Berlin H, Anderson E, Pan M, Shadid HR, Padalia K, O'Hayer P, Meloche
C, Feroze R, Michaud E, Launius C, Blakely P, Bitar A, Willer C, Pop-Busui R,
Carethers JM, Hayek SS
Submitted By Submitted Externally on 1/10/2022
Status Published
Journal The American journal of medicine
Year 2021
Date Published 11/1/2021
Volume : Pages Not Specified : Not Specified
PubMed Reference 34793753
Abstract Racial disparities in coronavirus disease 2019 (COVID-19) outcomes have been
described. We sought to determine whether differences in inflammatory markers,
use of COVID-19 therapies, enrollment in clinical trials, and in-hospital
outcomes contribute to racial disparities between Black and non-Black patients
hospitalized for COVID-19., We leveraged a prospective cohort study that
enrolled 1325 consecutive patients hospitalized for COVID-19, of whom 341
(25.7%) were Black. We measured biomarkers of inflammation and collected data on
the use COVID-19-directed therapies, enrollment in COVID-19 clinical trials,
mortality, need for renal replacement therapy, and need for mechanical
ventilation., Compared to non-Black patients, Black patients had a higher
prevalence of COVID-19 risk factors including obesity, hypertension, and
diabetes mellitus and were more likely to require renal replacement therapy
(15.8% vs 7.1%, P < .001) and mechanical ventilation (37.2% vs 26.6%, P < .001)
during their hospitalization. Mortality was similar between both groups (15.5%
for Blacks vs 14.0% for non-Blacks, P = .49). Black patients were less likely to
receive corticosteroids (44.9% vs 63.8%, P< .001) or remdesivir (23.8% vs 57.8%,
P < .001) and were less likely to be enrolled in COVID-19 clinical trials (15.3%
vs 28.2%, P < .001). In adjusted analyses, Black race was associated with lower
levels of C-reactive protein and soluble urokinase receptor and higher odds of
death, mechanical ventilation, and renal replacement therapy. Differences in
outcomes were not significant after adjusting for use of remdesivir and
corticosteroids., Racial differences in outcomes of patients with COVID-19 may
be related to differences in inflammatory response and differential use of
therapies.




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