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ORIGINAL ARTICLE
Year : 2021  |  Volume : 7  |  Issue : 2  |  Page : 81-88

COVID-19 clinical course and outcomes in a predominantly black, vulnerable patient population in New York City


Department of Emergency Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA

Correspondence Address:
Dr. Priyanka Parmar
571 E New York Ave, Apt 3C, Brooklyn NY 11225
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJAM.IJAM_116_20

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Introduction: A study examining the impact of social determinants of health on COVID-19 outcomes is necessary to identify which aspects of a vulnerable population make it more susceptible. We describe the epidemiological and clinical characteristics of a patient population disproportionately impacted by COVID-19 and situate the findings within the broader context of health determinants. Materials and Methods: A descriptive study of 527 laboratory-confirmed COVID-19 patients hospitalized from March 12 to April 13, 2020, evaluated patient demographics, comorbidities, presentation, and outcomes. The study took place at an academic medical center serving a low-income, Black community (predominantly Caribbean-born) in Brooklyn, New York. Results: Compared to previous studies, we report a higher median age of 70 (interquartile range 59–80), a higher percentage of Blacks (91%), a higher prevalence of comorbidities (hypertension [83%], diabetes [53%], and obesity [42%]), a higher prevalence of abnormal findings on presentation (altered mental status [30%], Quick sequential organ failure assessment score ≥2 [27%], elevated random-glucose [77%], elevated creatinine [57%]), and a higher incidence of negative in-hospital outcomes (intensive care unit admission [21%], mechanical ventilation [21%], acute kidney injury [31%], acute respiratory distress syndrome [17%] and acute cardiac injury [18%], and age-adjusted fatality rate [40%.]). Conclusions: This study shows the characteristics of a patient population disproportionately impacted by COVID-19. The intersectionality of the Black race, older age, a high prevalence of comorbidities, and residency in a locale severely affected by COVID-19, deserves further consideration to better address health outcomes in vulnerable patient groups. The following core competencies are addressed in this article: Practice-based learning and improvement, Patient care and Procedural skills, Systems-based practice.


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