Symptomatic, clinical and biomarker associations for mortality in hospitalized COVID-19 patients enriched for African Americans

dc.contributor.authorAshktorab, Hassan
dc.contributor.authorPizuorno, Antonio
dc.contributor.authorAdeleye, Folake
dc.contributor.authorLaiyemo, Adeyinka
dc.contributor.authorDalivand, Maryam Mehdipour
dc.contributor.authorAduli, Farshad
dc.contributor.authorSherif, Zaki A.
dc.contributor.authorOskrochi, Gholamreza
dc.contributor.authorAngesom, Kibreab
dc.contributor.authorOppong-Twene, Philip
dc.contributor.authorChalla, Suryanarayana Reddy
dc.contributor.authorOkorie, Nnaemeka
dc.contributor.authorMoon, Esther S.
dc.contributor.authorRomos, Edward
dc.contributor.authorJones-Wonni, Boubini
dc.contributor.authorKone, Abdoul Madjid
dc.contributor.authorRankine, Sheldon
dc.contributor.authorThrift, Camelita
dc.contributor.authorScholes, Derek
dc.contributor.authorEkwunazu, Chiamaka
dc.contributor.authorBanson, Abigail
dc.contributor.authorMitchell, Brianna
dc.contributor.authorMaskalo, Guttu
dc.contributor.authorRoss, Jillian
dc.contributor.authorCurtis, Julencia
dc.contributor.authorKim, Rachel
dc.contributor.authorGilliard, Chandler
dc.contributor.authorAhuja, Geetha
dc.contributor.authorMathew, Joseph
dc.contributor.authorGavin, Warren
dc.contributor.authorKara, Areeba
dc.contributor.authorHache-Marliere, Manuel
dc.contributor.authorPalaiodimos, Leonidas
dc.contributor.authorMani, Vishnu R.
dc.contributor.authorKalabin, Aleksandr
dc.contributor.authorGayam, Vijay Reddy
dc.contributor.authorGarlapati, Pavani Reddy
dc.contributor.authorMiller, Joseph
dc.contributor.authorChirumamilla, Lakshmi Gayathri
dc.contributor.authorJackson, Fatimah
dc.contributor.authorCarethers, John M.
dc.contributor.authorKamangar, Farin
dc.contributor.authorBrim, Hassan
dc.contributor.departmentMedicine, School of Medicineen_US
dc.date.accessioned2023-07-13T10:01:11Z
dc.date.available2023-07-13T10:01:11Z
dc.date.issued2022-06-17
dc.description.abstractBackground and aims: Initial reports on US COVID-19 showed different outcomes in different races. In this study we use a diverse large cohort of hospitalized COVID-19 patients to determine predictors of mortality. Methods: We analyzed data from hospitalized COVID-19 patients (n = 5852) between March 2020- August 2020 from 8 hospitals across the US. Demographics, comorbidities, symptoms and laboratory data were collected. Results: The cohort contained 3,662 (61.7%) African Americans (AA), 286 (5%) American Latinx (LAT), 1,407 (23.9%), European Americans (EA), and 93 (1.5%) American Asians (AS). Survivors and non-survivors mean ages in years were 58 and 68 for AA, 58 and 77 for EA, 44 and 61 for LAT, and 51 and 63 for AS. Mortality rates for AA, LAT, EA and AS were 14.8, 7.3, 16.3 and 2.2%. Mortality increased among patients with the following characteristics: age, male gender, New York region, cardiac disease, COPD, diabetes mellitus, hypertension, history of cancer, immunosuppression, elevated lymphocytes, CRP, ferritin, D-Dimer, creatinine, troponin, and procalcitonin. Use of mechanical ventilation (p = 0.001), shortness of breath (SOB) (p < 0.01), fatigue (p = 0.04), diarrhea (p = 0.02), and increased AST (p < 0.01), significantly correlated with death in multivariate analysis. Male sex and EA and AA race/ethnicity had higher frequency of death. Diarrhea was among the most common GI symptom amongst AAs (6.8%). When adjusting for comorbidities, significant variables among the demographics of study population were age (over 45 years old), male sex, EA, and patients hospitalized in New York. When adjusting for disease severity, significant variables were age over 65 years old, male sex, EA as well as having SOB, elevated CRP and D-dimer. Glucocorticoid usage was associated with an increased risk of COVID-19 death in our cohort. Conclusion: Among this large cohort of hospitalized COVID-19 patients enriched for African Americans, our study findings may reflect the extent of systemic organ involvement by SARS-CoV-2 and subsequent progression to multi-system organ failure. High mortality in AA in comparison with LAT is likely related to high frequency of comorbidities and older age among AA. Glucocorticoids should be used carefully considering the poor outcomes associated with it. Special focus in treating patients with elevated liver enzymes and other inflammatory biomarkers such as CRP, troponin, ferritin, procalcitonin, and D-dimer are required to prevent poor outcomes.en_US
dc.eprint.versionFinal published versionen_US
dc.identifier.citationAshktorab H, Pizuorno A, Adeleye F, et al. Symptomatic, clinical and biomarker associations for mortality in hospitalized COVID-19 patients enriched for African Americans [published correction appears in BMC Infect Dis. 2022 Aug 29;22(1):712]. BMC Infect Dis. 2022;22(1):552. Published 2022 Jun 17. doi:10.1186/s12879-022-07520-1en_US
dc.identifier.urihttps://hdl.handle.net/1805/34345
dc.language.isoen_USen_US
dc.publisherBMCen_US
dc.relation.isversionof10.1186/s12879-022-07520-1en_US
dc.relation.journalBMC Infectious Diseasesen_US
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.sourcePMCen_US
dc.subjectCOVID-19en_US
dc.subjectSARS CoV-2en_US
dc.subjectAfrican Americanen_US
dc.subjectHispanicen_US
dc.subjectRaceen_US
dc.subjectEthnicityen_US
dc.subjectMortalityen_US
dc.subjectHospitalizeden_US
dc.titleSymptomatic, clinical and biomarker associations for mortality in hospitalized COVID-19 patients enriched for African Americansen_US
dc.typeArticleen_US
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