09/22/2020
Please congratulate our own Priyanka Parmar, Jodi-Ann Edwards and Igal Breitman, as well as the other authors, on this paper!
COVID-19 Clinical Course and Outcomes in a Predominantly Black, Vulnerable Patient Population in New York City
Priyanka Parmar1, Alecia James MA1, Sabrina Rosengarten MPH1, Michael A. Joseph PhD MPH1, Mohamed Nakeshbandi MD1, Jodi-Ann Edwards MD1, Clara Wilson1, Alvin Oommen1, Rohan Maini1, Max Mecklenburg MPH1, Julie Kim1, Igal Breitman MD1, Bonnie Arquilla DO1, Pia Daniel MD MPH1
1 SUNY Downstate Health Sciences University
450 Clarkson Ave
Brooklyn, NY 11203
Abstract
Objective: To describe the epidemiological and clinical characteristics of a patient population highly impacted by COVID-19 and situate the findings within the broader context of health determinants.
Methods: The study took place at an academic, state-designated COVID-only, medical center serving a low-income Black community in Kings County, New York. This descriptive study of 527 laboratory-confirmed COVID-19 patients hospitalized from March 12 - April 13, 2020 evaluated patient demographics, comorbidities, presentation, and outcomes.
Results: Compared to previous studies, we report a higher median age of 70 (IQR 59 – 80), a higher percentage of Blacks (91%), a higher prevalence of comorbidities (cardiovascular disease [86%], hypertension [83%], diabetes [53%], and obesity [42%]), a higher prevalence of abnormal findings on presentation (altered mental status [30%], qSOFA score 2 [27%], elevated random-glucose [77%], elevated creatinine [57%]), and a higher incidence of negative in-hospital outcomes (intensive care unit admission [21%], mechanical ventilation [21%], acute kidney injury [31%], acute respiratory distress syndrome [17%], acute cardiac injury [18%], and age-adjusted fatality rate [40%]).
Conclusion/Implications: This study shows the characteristics of a patient population disproportionately impacted by COVID-19 in the county with the second-highest death rate in the US to date. COVID-19 has seriously magnified the impact of long-standing health disparities in underserved populations. The intersectionality of the Black race, older age, a high prevalence of comorbidities, and residency in a locale severely affected by COVID-19, deserves further consideration to better address health outcomes in vulnerable patient groups. This will help to guide polices and ensure better health outcomes.
