Hispanic ethnicity and mortality among critically ill patients with COVID-19

• Published in: PloS one Vol. 17; no. 5; p. e0268022
• Main Authors: Ricardo, Ana C, Chen, Jinsong, Toth-Manikowski, Stephanie M, Meza, Natalie, Joo, Min, Gupta, Shruti, Lazarous, Deepa G, Leaf, David E, Lash, James P
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 18.05.2022; Public Library of Science (PLoS)
• Subjects: Adult; Adults; Aged; Biology and Life Sciences; Chronic obstructive pulmonary disease; Cohort Studies; Comorbidity; Congestive heart failure; Coronary artery; Coronary artery disease; Coronaviruses; COVID-19; Critical Illness; Critically ill; Ethnicity; Fatalities; Female; Health aspects; Health risks; Heart diseases; Hispanic Americans; Hospital Mortality; Hospitals; Humans; Hypertension; Intensive Care Units; Lung diseases; Male; Medicine and Health Sciences; Middle Aged; Minority & ethnic groups; Mortality; Obstructive lung disease; Patient outcomes; Patients; People and Places; Pulmonary artery; SARS-CoV-2; Signs and symptoms; United States - epidemiology; Viral diseases; United States; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0268022

Hispanic persons living in the United States (U.S.) are at higher risk of infection and death from coronavirus disease 2019 (COVID-19) compared with non-Hispanic persons. Whether this disparity exists among critically ill patients with COVID-19 is unknown. To evaluate ethnic disparities in mortality among critically ill adults with COVID-19 enrolled in the Study of the Treatment and Outcomes in Critically Ill Patients with COVID-19 (STOP-COVID). Multicenter cohort study of adults with laboratory-confirmed COVID-19 admitted to intensive care units (ICU) at 67 U.S. hospitals from March 4 to May 9, 2020. Multilevel logistic regression was used to evaluate 28-day mortality across racial/ethnic groups. A total of 2153 patients were included (994 [46.2%] Hispanic and 1159 [53.8%] non-Hispanic White). The median (IQR) age was 62 (51-71) years (non-Hispanic White, 66 [57-74] years; Hispanic, 56 [46-67] years), and 1462 (67.9%) were men. Compared with non-Hispanic White patients, Hispanic patients were younger; were less likely to have hypertension, chronic obstructive pulmonary disease, coronary artery disease, or heart failure; and had longer duration of symptoms prior to ICU admission. During median (IQR) follow-up of 14 (7-24) days, 785 patients (36.5%) died. In analyses adjusted for age, sex, clinical characteristics, and hospital size, Hispanic patients had higher odds of death compared with non-Hispanic White patients (OR, 1.44; 95% CI, 1.12-1.84). Among critically ill adults with COVID-19, Hispanic patients were more likely to die than non-Hispanic White patients, even though they were younger and had lower comorbidity burden. This finding highlights the need to provide earlier access to care to Hispanic individuals with COVID-19, especially given our finding of longer duration of symptoms prior to ICU admission among Hispanic patients. In addition, there is a critical need to address ongoing disparities in post hospital discharge care for patients with COVID-19.