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Racial/ethnic and neighbourhood social vulnerability disparities in COVID-19 testing positivity, hospitalization, and in-hospital mortality in a large hospital system in Pennsylvania: A prospective study of electronic health records.


ABSTRACT:

Background

Disparities in COVID-19 mortality by race/ethnicity or neighborhood have been documented using surveillance data. We aimed to describe disparities by race/ethnicity and neighbourhood social vulnerability in COVID-19 positivity, hospitalization, and mortality.

Methods

We obtained data from the electronic health records of all individuals who tested positive for COVID-19 in the University of Pennsylvania Health System (UPHS) or were hospitalized with confirmed COVID-19 infection in five UPHS hospitals from March 1, 2020, to March 31, 2021. The main predictors were race/ethnicity and neighbourhood-level social vulnerability. The main outcomes were COVID-19 test positivity, hospitalization with COVID-19, and 30-day in-hospital mortality following hospitalization with COVID-19.

Findings

A total of 225,129 unique individuals received COVID-19 testing and 18,995 had a positive test result. A total of 5,794 unique patients were hospitalized with COVID-19 and 511 died in-hospital within 30 days. Racial/ethnic minority groups and residents of higher social vulnerability neighbourhoods had higher test positivity and risk of hospitalization. We did not see in-hospital mortality disparities during the first wave but observed 75% and 68% higher odds of death among Hispanic and Asians compared to Whites during subsequent waves.

Interpretation

We observed significant racial/ethnic and neighbourhood disparities in COVID-19 outcomes, especially test positivity and odds of hospitalization, highlighting the importance of equitably improving access to preventive measures to reduce SARS-CoV-2 infection, including reducing exposure to the virus and ensuring equity in vaccination.

Funding

National Institutes of Health.

SUBMITTER: Bilal U 

PROVIDER: S-EPMC8891851 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Publications

Racial/ethnic and neighbourhood social vulnerability disparities in COVID-19 testing positivity, hospitalization, and in-hospital mortality in a large hospital system in Pennsylvania: A prospective study of electronic health records.

Bilal Usama U   Jemmott John B JB   Schnake-Mahl Alina A   Murphy Kathleen K   Momplaisir Florence F  

Lancet regional health. Americas 20220303


<h4>Background</h4>Disparities in COVID-19 mortality by race/ethnicity or neighborhood have been documented using surveillance data. We aimed to describe disparities by race/ethnicity and neighbourhood social vulnerability in COVID-19 positivity, hospitalization, and mortality.<h4>Methods</h4>We obtained data from the electronic health records of all individuals who tested positive for COVID-19 in the University of Pennsylvania Health System (UPHS) or were hospitalized with confirmed COVID-19 in  ...[more]

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