Details
Epidemiologic data1-4 indicate that communities of color continue to be disproportionally impacted by the ongoing COVID-19 pandemic. We sought to determine the association between race and COVID-19 outcomes among persons diagnosed or hospitalized with COVID-19, after adjusting for relevant clinical and demographic risk factors.
Our specific aims were:
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To evaluate the association between race and hospitalization with COVID-19 among patients diagnosed with COVID-19 after adjusting for demographic and clinical risk factors.
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To evaluate the association between race and critical COVID-19 disease among patients hospitalized with COVID-19 after adjusting for demographic and clinical risk factors.
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To evaluate the association between race and mortality among patients hospitalized with COVID-19 after adjusting for demographic and clinical risk factors.
To meet these aims, we identified cohorts of individuals who had evidence of a COVID-19 infection and separately evaluated the occurrence of any hospitalization with COVID-19 and hospitalization with COVID-19 without elements of critical COVID-19 within 30 days of cohort entry. We also identified cohorts of individuals who were hospitalized with COVID-19, and separately evaluated the occurrence of hospitalization with critical COVID-19, inpatient all-cause mortality, or any all-cause mortality within 30 days of cohort entry. We described all study cohorts at baseline by race, urbanicity, and outcome status. We evaluated crude and adjusted associations between race and COVID-19 outcomes using univariate and multivariable logistic regression models run at each Data Partner site.
Effect estimates from all participating sites were individually reviewed for any warnings related to model convergence. Only results for those sites where the multivariable outcome regression models converged without any warnings are included in the final study report published on our website. Site-specific estimates were pooled at Sentinel Operations Center in a random-effects meta-analysis using local plus programming. A publicly available macro was used to conduct the meta-analysis.
The analytic package associated with this analysis can be found externally in Sentinel's Git Repository located here. The Git Repository serves as Sentinel's version control tracking system for analytic packages and technical documentation
Sources:
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Laboratory Confirmed COVID-19-Associated Hospitalizations. https://gis.cdc.gov/grasp/COVIDNet/COVID19_3.html
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The Color of Coronavirus: COVID-19 Deaths by Race and Ethnicity in the U.S. https://www.apmresearchlab.org/covid/deaths-by-race
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United States Census Bureau. Quick Facts. https://www.census.gov/quickfacts/fact/table/US/PST045219
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CDC COVID Data Tracker. https://covid.cdc.gov/covid-data-tracker/#demographics
This project was funded by U.S. Food and Drug Administration (FDA) Office of Minority Health and Health Equity (OMHHE).
Additional Information
Contributors
Sruthi Adimadhyam, PhD, MS; Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA
Adebola Ajao, PhD, MPH; Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD
Rebecca Hawrusik, MS; Andrew Petrone, MPH; Megan Hiley, MPH; Jolene Mosley, BA; Jen Thompson, MPP; Whitney Chlon, MPH; Elizabeth Siranosian, BA; Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA
Efe Eworuke, PhD, MSc; Danijela Stojanovic, PharmD, PhD; Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD
Hye Seung Lee, PhD; Office of Biometrics, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD
Caroline Jjingo, MD, MPH; Office of New Drug, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD
Jane Baumblatt, MD; Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD