ArticleEClinicalMedicine2021
Racial and ethnic disparity in clinical outcomes among patients with confirmed COVID-19 infection in a large US electronic health record database.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Telehealth Use and Health Equity for Mental Health and Substance Use Disorder During the COVID-19 Pandemic: A Systematic Review.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2024Pooled it
- Use of social media platforms by migrant and ethnic minority populations during the COVID-19 pandemic: a systematic review.BMJ open · 2022Pooled it
- Feasibility of wearable sensor signals and self-reported symptoms to prompt at-home testing for acute respiratory viruses in the USA (DETECT-AHEAD): a decentralised, randomised controlled trial.The Lancet. Digital health · 2024Trial
- Racial and Ethnic Differences in COVID-19 Disease Severity Among US Adults in Health Systems Participating in PCORnet®: May 2020-October 2022.Medical care · 2026Article
- Racial and Ethnic Disparities in COVID-19 Treatments in the United States.Journal of racial and ethnic health disparities · 2025Article
- Drug utilisation patterns & clinical outcomes in hospitalised COVID-19 patients: A geospatial & machine learning approach.The Indian journal of medical research · 2025Article
- Health diagnosis associated with COVID-19 death in the United States: A retrospective cohort study using electronic health records.PloS one · 2025Article
- Disparities in COVID-19-Related Mortality Among Older Adults With Alzheimer's Disease and Related Dementias: Variations Over Time.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2025Observational
- Impact of Obesity-Associated SARS-CoV-2 Mutations on COVID-19 Severity and Clinical Outcomes.Viruses · 2024Article
- Social Disparities and Critical Illness during the Coronavirus Disease 2019 Pandemic: A Narrative Review.Critical care clinics · 2024Review
- Race, Ethnicity, and Delayed Time to COVID-19 Testing Among US Health Care Workers.JAMA network open · 2024Article
- Trial staff and community member perceptions of barriers and solutions to improving racial and ethnic diversity in clinical trial participation; a mixed method study.Contemporary clinical trials communications · 2024Article
- Exploring the Relation between Contextual Social Determinants of Health and COVID-19 Occurrence and Hospitalization.Informatics (MDPI) · 2024Article
- Article
- The politics of COVID-19: Differences between U.S. red and blue states in COVID-19 regulations and deaths.Health policy OPEN · 2023Article
- Factors associated with bleeding complications in patients with coronavirus disease 2019 admitted to intensive care units: A multicenter retrospective cohort study.Journal of diabetes investigation · 2023Observational
- A call to action to improve the completeness of older adult sexual and gender minority data in electronic health records.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Twelve-Month Follow-up of the Immune Response After COVID-19 Vaccination in Patients with Genitourinary Cancers: A Prospective Cohort Analysis.The oncologist · 2023Article
- Beyond rhetoric in the pandemic treaty: Prioritizing equity and inclusion for marginalized populations.Public health challenges · 2023Article
- Racial and Socioeconomic Disparities in Multisystem Inflammatory Syndrome in Children in the United States.The American journal of cardiology · 2023Article
Corrections and comments
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Authors and funding
16 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRacial and ethnic minority groups have been disproportionately affected by the US coronavirus disease 2019 (COVID-19) pandemic; however, nationwide data on COVID-19 outcomes stratified by race/ethnicity and adjusted for clinical characteristics are sparse. This study analyzed the impacts of race/ethnicity on outcomes among US patients with COVID-19.
methodsThis was a retrospective observational study of patients with a confirmed COVID-19 diagnosis in the electronic health record from 01 February 2020 through 14 September 2020. Index encounter site, hospitalization, and mortality were assessed by race/ethnicity (Hispanic, non-Hispanic Black [Black], non-Hispanic White [White], non-Hispanic Asian [Asian], or Other/unknown). Associations between racial/ethnic categories and study outcomes adjusted for patient characteristics were evaluated using logistic regression.
findingsAmong 202,908 patients with confirmed COVID-19, patients from racial/ethnic minority groups were more likely than White patients to be hospitalized on initial presentation (Hispanic: adjusted odds ratio 1·690, 95% CI 1·620-1·763; Black: 1·810, 1·743-1·880; Asian: 1·503, 1·381-1·636) and during follow-up (Hispanic: 1·700, 1·638-1·764; Black: 1·578, 1·526-1·633; Asian: 1·391, 1·288-1·501). Among hospitalized patients, adjusted mortality risk was lower for Black patients (0·881, 0·809-0·959) but higher for Asian patients (1·205, 1·000-1·452).
interpretationRacial/ethnic minority patients with COVID-19 had more severe disease on initial presentation than White patients. Increased mortality risk was attenuated by hospitalization among Black patients but not Asian patients, indicating that outcome disparities may be mediated by distinct factors for different groups. In addition to enacting policies to facilitate equitable access to COVID-19-related care, further analyses of disaggregated population-level COVID-19 data are needed.
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