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Buikema AR, Buzinec P, Paudel ML, et al. Racial and ethnic disparity in clinical outcomes among patients with confirmed COVID-19 infection in a large US electronic health record database. EClinicalMedicine. 2021;39:101075doi: 10.1016/j.eclinm.2021.101075.
Buikema, A. R., Buzinec, P., Paudel, M. L., Andrade, K., Johnson, J. C., Edmonds, Y. M., Jhamb, S. K., Chastek, B., Raja, H., Cao, F., Hulbert, E. M., Korrer, S., Mazumder, D., Seare, J., Solow, B. K., & Currie, U. M. (2021). Racial and ethnic disparity in clinical outcomes among patients with confirmed COVID-19 infection in a large US electronic health record database. EClinicalMedicine, 39101075. https://doi.org/10.1016/j.eclinm.2021.101075
Buikema, Ami R, et al. "Racial and ethnic disparity in clinical outcomes among patients with confirmed COVID-19 infection in a large US electronic health record database." EClinicalMedicine vol. 39 (2021): 101075. doi: https://doi.org/10.1016/j.eclinm.2021.101075
Buikema AR, Buzinec P, Paudel ML, Andrade K, Johnson JC, Edmonds YM, Jhamb SK, Chastek B, Raja H, Cao F, Hulbert EM, Korrer S, Mazumder D, Seare J, Solow BK, Currie UM. Racial and ethnic disparity in clinical outcomes among patients with confirmed COVID-19 infection in a large US electronic health record database. EClinicalMedicine. 2021 Sep;39:101075. doi: 10.1016/j.eclinm.2021.101075. Epub 2021 Sep 03. PMID: 34493997; PMCID: PMC8413267.
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EClinicalMedicine. 2021 Sep;39:101075. doi: 10.1016/j.eclinm.2021.101075. Epub 2021 Sep 03.

Racial and ethnic disparity in clinical outcomes among patients with confirmed COVID-19 infection in a large US electronic health record database.

EClinicalMedicine

Ami R Buikema, Paul Buzinec, Misti L Paudel, Katherine Andrade, Jonathan C Johnson, Yvette M Edmonds, Sumit K Jhamb, Benjamin Chastek, Harish Raja, Feng Cao, Erin M Hulbert, Stephanie Korrer, Dibyajyoti Mazumder, Jerry Seare, Brian K Solow, U Michael Currie

Affiliations

  1. Optum, Eden Prairie, MN, USA.
  2. Optum, Noida, India.
  3. Optum, Boston, MA, USA.
  4. Optum, Irvine, CA, USA.
  5. UnitedHealth Group, Minnetonka, MN, USA.

PMID: 34493997 PMCID: PMC8413267 DOI: 10.1016/j.eclinm.2021.101075

Abstract

BACKGROUND: Racial and ethnic minority groups have been disproportionately affected by the US coronavirus disease 2019 (COVID-19) pandemic; however, nationwide data on COVID-19 outcomes stratified by race/ethnicity and adjusted for clinical characteristics are sparse. This study analyzed the impacts of race/ethnicity on outcomes among US patients with COVID-19.

METHODS: This was a retrospective observational study of patients with a confirmed COVID-19 diagnosis in the electronic health record from 01 February 2020 through 14 September 2020. Index encounter site, hospitalization, and mortality were assessed by race/ethnicity (Hispanic, non-Hispanic Black [Black], non-Hispanic White [White], non-Hispanic Asian [Asian], or Other/unknown). Associations between racial/ethnic categories and study outcomes adjusted for patient characteristics were evaluated using logistic regression.

FINDINGS: Among 202,908 patients with confirmed COVID-19, patients from racial/ethnic minority groups were more likely than White patients to be hospitalized on initial presentation (Hispanic: adjusted odds ratio 1·690, 95% CI 1·620-1·763; Black: 1·810, 1·743-1·880; Asian: 1·503, 1·381-1·636) and during follow-up (Hispanic: 1·700, 1·638-1·764; Black: 1·578, 1·526-1·633; Asian: 1·391, 1·288-1·501). Among hospitalized patients, adjusted mortality risk was lower for Black patients (0·881, 0·809-0·959) but higher for Asian patients (1·205, 1·000-1·452).

INTERPRETATION: Racial/ethnic minority patients with COVID-19 had more severe disease on initial presentation than White patients. Increased mortality risk was attenuated by hospitalization among Black patients but not Asian patients, indicating that outcome disparities may be mediated by distinct factors for different groups. In addition to enacting policies to facilitate equitable access to COVID-19-related care, further analyses of disaggregated population-level COVID-19 data are needed.

© 2021 The Authors.

Keywords: COVID-19; Electronic Health Records; Ethnic Groups; Minority Groups; Retrospective Studies; SARS-CoV-2; United States

Conflict of interest statement

Ami Buikema, Paul Buzinec, Katherine Andrade, Jonathan Johnson, Yvette Edmonds, Sumit Jhamb, Benjamin Chastek, Harish Raja, Feng Cao, Erin Hulbert, Stephanie Korrer, Dibyajyoti Mazumder, Jerry Seare,

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