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Azam TU, Berlin H, Anderson E, et al. Differences in Inflammation, Treatment, and Outcomes Between Black and Non-Black Patients Hospitalized for COVID-19: A Prospective Cohort Study. Am J Med. 2021;doi: 10.1016/j.amjmed.2021.10.026.
Azam, T. U., Berlin, H., Anderson, E., Pan, M., Shadid, H. R., Padalia, K., O'Hayer, P., Meloche, C., Feroze, R., Michaud, E., Launius, C., Blakely, P., Bitar, A., Willer, C., Pop-Busui, R., Carethers, J. M., & Hayek, S. S. (2021). Differences in Inflammation, Treatment, and Outcomes Between Black and Non-Black Patients Hospitalized for COVID-19: A Prospective Cohort Study. The American journal of medicine, . https://doi.org/10.1016/j.amjmed.2021.10.026
Azam, Tariq U, et al. "Differences in Inflammation, Treatment, and Outcomes Between Black and Non-Black Patients Hospitalized for COVID-19: A Prospective Cohort Study." The American journal of medicine vol. (2021). doi: https://doi.org/10.1016/j.amjmed.2021.10.026
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. Differences in Inflammation, Treatment, and Outcomes Between Black and Non-Black Patients Hospitalized for COVID-19: A Prospective Cohort Study. Am J Med. 2021 Nov 16; doi: 10.1016/j.amjmed.2021.10.026. Epub 2021 Nov 16. PMID: 34793753; PMCID: PMC8592847.
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Am J Med. 2021 Nov 16; doi: 10.1016/j.amjmed.2021.10.026. Epub 2021 Nov 16.

Differences in Inflammation, Treatment, and Outcomes Between Black and Non-Black Patients Hospitalized for COVID-19: A Prospective Cohort Study.

The American journal of medicine

Tariq U Azam, Hanna Berlin, Elizabeth Anderson, Michael Pan, Husam R Shadid, Kishan Padalia, Patrick O'Hayer, Chelsea Meloche, Rafey Feroze, Erinleigh Michaud, Christopher Launius, Penelope Blakely, Abbas Bitar, Cristen Willer, Rodica Pop-Busui, John M Carethers, Salim S Hayek

Affiliations

  1. Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor.
  2. University of Michigan Medical School, Ann Arbor.
  3. Department of Internal Medicine, University of Michigan, Ann Arbor.
  4. Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.
  5. Division of Gastroenterology & Hepatology, Department of Internal Medicine and Department of Human Genetics, University of Michigan, Ann Arbor.
  6. Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor. Electronic address: [email protected].

PMID: 34793753 PMCID: PMC8592847 DOI: 10.1016/j.amjmed.2021.10.026

Abstract

PURPOSE: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: Racial differences in outcomes of patients with COVID-19 may be related to differences in inflammatory response and differential use of therapies.

Copyright © 2021 Elsevier Inc. All rights reserved.

Keywords: African Americans; Convalescent serum; Coronavirus; Corticosteroids; Disparities; M2C2; Remdesivir; SARS-COV-2

References

  1. Ann Intern Med. 2021 Mar;174(3):362-373 - PubMed
  2. Circulation. 2005 Mar 15;111(10):1233-41 - PubMed
  3. MMWR Morb Mortal Wkly Rep. 2020 Apr 17;69(15):458-464 - PubMed
  4. J Health Care Poor Underserved. 2006 Nov;17(4):698-715 - PubMed
  5. Med Care. 2009 Sep;47(9):1009-17 - PubMed
  6. N C Med J. 2016 Jan-Feb;77(1):52-8 - PubMed
  7. JAMA Pediatr. 2015 Nov;169(11):996-1002 - PubMed
  8. N Engl J Med. 2020 Jul 16;383(3):201-203 - PubMed
  9. J Am Geriatr Soc. 2020 Feb;68(2):362-369 - PubMed
  10. Am J Ther. 2008 Jan-Feb;15(1):3-11 - PubMed
  11. JAMA. 2009 Sep 16;302(11):1195-201 - PubMed
  12. Semin Nephrol. 2013 Sep;33(5):409-15 - PubMed
  13. JAMA Netw Open. 2020 Aug 3;3(8):e2018696 - PubMed
  14. Transplantation. 2020 Jul;104(7):1437-1444 - PubMed
  15. N Engl J Med. 2020 Jun 25;382(26):2534-2543 - PubMed
  16. N Engl J Med. 2002 May 2;346(18):1373-82 - PubMed
  17. JAMA Netw Open. 2020 Aug 3;3(8):e2018039 - PubMed
  18. JAMA Netw Open. 2020 Dec 1;3(12):e2026881 - PubMed
  19. JAMA Netw Open. 2020 Oct 1;3(10):e2025197 - PubMed
  20. Oncologist. 2018 Sep;23(9):1076-1078 - PubMed
  21. JAMA. 2020 May 19;323(19):1891-1892 - PubMed
  22. Diabetes Metab Syndr. 2020 Sep - Oct;14(5):1043-1051 - PubMed
  23. Public Health. 2021 Jan;190:93-98 - PubMed
  24. J Intern Med. 2021 Apr;289(4):463-473 - PubMed
  25. J Am Coll Cardiol. 2005 Aug 2;46(3):464-9 - PubMed
  26. JCI Insight. 2021 Feb 22;6(4): - PubMed
  27. Cancer. 2013 Aug 15;119(16):2956-63 - PubMed
  28. Cancer. 2020 Jan 1;126(9):1958-1968 - PubMed
  29. JAMA. 2020 Jun 23;323(24):2466-2467 - PubMed
  30. JAMA Cardiol. 2018 Oct 1;3(10):1011-1019 - PubMed
  31. JAMA Netw Open. 2020 Sep 1;3(9):e2019795 - PubMed

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