Characteristics and clinical outcomes of COVID-19 patients in an underserved-inner city population: A single tertiary center cohort

J Med Virol. 2021 Jan;93(1):416-423. doi: 10.1002/jmv.26252. Epub 2020 Jul 15.

Abstract

There is limited information describing the characteristics and clinical outcomes of patients infected with coronavirus disease 2019 (COVID-19) especially those in underserved urban area with minority population in the United States. This is a retrospective single-center study for patients who were admitted with COVID-19 infection. Data collection was from 1 March through 24 April 2020. Demographic, clinical, laboratory, and treatment data were presented using descriptive statistics and frequencies. The χ2 test and multivariate logistic regression were used to determine association of risk factors and clinical outcomes. A total of 242 inpatients were included with a mean age of 66 ± 14.75 (±standard deviation). A total of 50% were female and 70% were African American. Comorbidities included hypertension (74%), diabetes mellitus (49%), and 19% had either COPD or asthma. Older age was associated with higher risk of inpatient death odds ratio (OR): 1.056 (95% confidence interval [CI]: 1.023-1.090; P = .001). Inpatient mortality occurred in 70% who needed mechanical ventilation (OR: 29.51; 95% CI: 13.28-65.60; P < .0001), 58% who required continuous renal replacement therapy/hemodialysis (CRRT/HD) (OR: 6.63; 95% CI: 2.74-16.05; P < .0001), and 69% who needed vasopressors (OR: 30.64; 95% CI: 13.56-69.20; P < .0001). Amongst biomarkers of disease severity, only baseline CRP levels (145 ± 116 mg/L) were associated with mortality OR: 1.008 (95% CI: 1.003-1.012; P = .002). Majority of hospitalized patients had hypertension and diabetes. Older age was an independent risk factor for inpatient mortality. Requirement of mechanical ventilation, vasopressor use, and CRRT/HD was associated significantly with inpatient mortality. Higher baseline CRP was significantly associated with inpatient death.

Keywords: COVID-19; coronavirus; inner city hospital; outcomes.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antimalarials / therapeutic use
  • Antiviral Agents / therapeutic use
  • Biomarkers / blood
  • COVID-19 / mortality*
  • COVID-19 / pathology*
  • COVID-19 Drug Treatment
  • Cities
  • Cohort Studies
  • Female
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Inflammation / blood
  • Inflammation / metabolism
  • Male
  • Medically Underserved Area*
  • Middle Aged
  • Retrospective Studies
  • SARS-CoV-2*
  • Steroids / therapeutic use
  • Tertiary Care Centers*
  • United States

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal, Humanized
  • Antimalarials
  • Antiviral Agents
  • Biomarkers
  • Steroids
  • Hydroxychloroquine
  • tocilizumab