"Although in-hospital mortality and major adverse cardiovascular events (MACE) did not differ by race/ethnicity, Black and Hispanic patients bore a greater burden of mortality and morbidity due to their disproportionate representation among COVID-19 hospitalizations," according to Fatima Rodriguez, MD, MPH, FACC, et al., as part of a COVID-19 late-breaking science session Nov. 17 during AHA 2020.

The findings, which were simultaneously published in Circulation, are based on an analysis of data on 7,868 patients hospitalized with COVID-19 at 88 U.S. hospitals participating in the America Heart Association COVID-19 Cardiovascular Disease Registry between Jan. 17 and July 22. The primary outcome was in-hospital mortality and secondary outcomes included MACE and COVID-19 cardiorespiratory ordinal severity score. Rodriguez and colleagues used multivariable logistic regression analyses to assess the relationship between race/ethnicity and each outcome adjusting for sociodemographic, clinical and presentation differences.

Of the patients analyzed for the study, Black and Hispanic patients accounted for over 50% of the hospitalizations. Specifically, 33.0% were Hispanic, 25.5% were non-Hispanic Black, 6.3% were Asian, and 35.2% were non-Hispanic White. Researchers noted that Hispanic and Black patients were younger than non-Hispanic White and Asian patients, and were more likely to be uninsured. Black patients also had the highest prevalence of obesity, hypertension and diabetes.

In terms of treatment and presentation symptoms, Black patients had the highest rates of mechanical ventilation (23.2%) and renal replacement therapy (6.6%) but the lowest rates of remdesivir use (6.1%), compared with other racial/ethnic groups. Asian patients had the highest COVID-19 cardiorespiratory severity at presentation. Of the 18.4% of patients who died, more than half were Black and Hispanic. Results were similar for MACE, Rodriguez, et al., said.

Based on the findings, the authors suggest that "interventions to reduce disparities in COVID-19 should focus upstream from hospitalization."

Clinical Topics: COVID-19 Hub

Keywords: AHA Annual Scientific Sessions, AHA20, COVID-19, severe acute respiratory syndrome coronavirus 2

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