COVID-19 Severity Elevated for Black and Latinx Rheumatic Patients

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Black and Latinx COVID-19 patients in the United States who suffer from rheumatic conditions are more likely to require hospitalization and invasive ventilation than their White counterparts, a new study suggests.

COVID-19 outcomes minorities

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Black and Latinx COVID-19 patients in the United States who suffer from rheumatic conditions are more likely to require hospitalization and invasive ventilation than their White counterparts, a new study suggests.

“Understanding disparities in COVID-19 outcomes can help us identify vulnerable populations and ensure that patients at high risk are adequately tested and treated,” said Milena Gianfrancesco, Ph.D., MPH, assistant professor of medicine at the University of California San Francisco. She presented the findings at the annual meeting of the American College of Rheumatology on Friday.

Abundant research suggests that the COVID-19 burden has fallen especially hard on minority communities, and that people with rheumatic disease, particularly those on immunosuppressants, may be at higher risk for severe infections. But until now, no studies had specifically investigated racial disparities in COVID-19 outcomes among rheumatic patients, Dr. Gianfrancesco said.

To fill this gap, Dr. Gianfrancesco and her team analyzed records of 694 US patients in the Global Rheumatology Registry, an international collection of data on patients with rheumatic diseases who have been diagnosed with COVID-19, from March 24 to May 22.

The researchers measured health outcomes including rates of hospitalization, ventilation support, and mortality. They controlled for sex, smoking status, age, rheumatic disease diagnoses, health problems common in rheumatic patient population (including cardiovascular disease, hypertension, lung disease, diabetes, and chronic renal insufficiency or end-stage retinal disease), and prescriptions for common arthritis medications including immunosuppressants.

The study revealed that Latinx patients had 1.98 times higher odds than Whites of requiring hospitalization for COVID-19. Black patients had 2.7 times higher odds of requiring hospitalization than Whites. And Black and Latinx patients had 3 times higher odds of needing ventilation. However Black and Latinx rheumatic patients did not suffer from higher COVID-19 mortality rates than White patients.

Dr. Gianfrancesco speculated that the disparity in rates of hospitalization may be due to a variety of factors including, access to testing, access to care, and living and working environments. For example, she said, Black and Latinx patients may be more likely to hold public-facing roles and may live in more densely populated homes.

“It’s very likely that the disparities we witnessed in COVID-19 outcomes reflect preexisting health disparities in our population,” she said.

Dr. Gianfrancesco expressed the hope that her team’s findings could lead to further research into health disparities in minority communities as well as public health policy changes such distribution of information about COVID-19 in multiple languages and targeted testing for COVID-19 in high-risk communities.

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REFERENCE

ABSTRACT NUMBER: 0006 • ACR Convergence 2020. "Race/ethnicity Is Associated with Poor Health Outcomes Amongst Rheumatic Disease Patients Diagnosed with COVID-19 in the US: Data from the COVID-19 Global Rheumatology Alliance Physician-Reported Registry." Friday, November 6, 2020

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