Racial and Ethnic Disparities and the National Burden of Covid-19 on Inpatient Hospitalizations

A Retrospective Study in the United States in the Year 2020

Bibliographic Data

ID2073384
AuthorsAmanda Nguyen (0000-0003-4288-3457, University of California Davis Medical Center, corresponding author), Russell G Buhr (0000-0001-6159-7435, University of California, Los Angeles), Gregg C Fonarow (0000-0002-3192-8093, University of California, Los Angeles), Jeffrey J Hsu (0000-0002-9971-5916, VA Greater Los Angeles Healthcare System), Arleen F Brown (0000-0001-9948-8955, University of California, Los Angeles), Boback Ziaeian (0000-0001-9787-3649, UCLA Health)
Year2025
Volume12
Issue4
Pages2509-2520
Publication date2025-08-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Racial and Ethnic Health Disparities (JOURNAL)
Journal identifiersISSN: 2196-8837 • E-ISSN: 2197-3792
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1007/s40615-024-02069-y
PMID39316343
OpenAlexW4402759826
LanguageEN
Citations received2
References cited33

Background Since January 2020, COVID-19 has affected more than 100 million people in the U.S. Previous studies on racial and ethnic disparities related to characteristics and outcomes of COVID-19 patients have been insightful. However, appropriate epidemiologic age-standardization of the disease burden and disparities for hospitalization data are lacking. Objective To identify and describe racial and ethnic disparities for primary COVID-19 hospitalizations in the U.S. in 2020. Methods In this nationally representative observational study, we use the National Inpatient Sample to quantify racial and ethnic disparities in COVID-19 hospitalizations. Descriptive statistics for patient characteristics, common comorbidities, age-standardized hospitalization rates, inpatient complications, and mortality among COVID-19 hospitalizations were contrasted by race and ethnicity. Results There were 1,058,815 primary COVID-19 hospitalizations in 2020. Of those, 47.2% were female, with median age of 66 (IQR, 54, 77). Overall inpatient mortality rate was 11.1%. When compared to White patients, Black, Hispanic, and Native American patients had higher age-standardized hospitalization rate ratios of 2.42 (95% CI 2.40-2.43), 2.26 (2.25-2.28), and 2.51 (2.46-2.56), respectively. Non-White patients had increased age-adjusted rates for procedures and complications. Factors associated with inpatient mortality include age, male sex, Hispanic or Native American race or ethnicity, lower income, Medicaid, heart failure, arrhythmias, coagulopathy, and chronic liver disease. Conclusions Marginalized populations in the U.S. had over twice the COVID-19 hospitalization rate relative to White patients. Age-adjusted mortality rates were highest for Black, Hispanic, and Native American patients. Careful consideration for vulnerable populations is encouraged during highly communicable respiratory pandemics

Ethnic group · Health care · Medicaid · Mortality rate · Observational study · Retrospective cohort study · COVID-19 and healthcare impacts · COVID-19 Clinical Research Studies · Demography · Emergency and Acute Care Studies · Medicine · Epidemiology · Gerontology · Internal Medicine

Tools

Open DOIOpen Access