While Black patients were more likely to test positive for COVID-19 than white patients at NYU Langone Health this spring, they had a lower risk of death and severe illness after hospitalization, according to a study published Dec. 4 in JAMA Network Open.
Researchers evaluated EHR data for 9,722 patients tested for COVID-19 at the New York City-based health system between March 1 and April 8. More than 4,800 tested positive for COVID-19, of which 2,623 were hospitalized.
Results showed Black patients were less likely to die or be discharged to hospice compared to white patients after hospitalization and had a lower risk of critical illness. Results were fully adjusted for age, sex, insurance status, comorbidities and neighborhood socioeconomic data. After adjustment, there were no significant differences in death risk between white patients and Hispanic and Asian patients. Asian patients were less likely to test positive for COVID-19, but more likely to be hospitalized compared to white patients.
"We do see a bit of a paradox," said Joseph Ravenell, MD, study author and associate professor at NYU Grossman School of Medicine's Department of Population Health. "In keeping with other research, we've found that once Black patients with COVID-19 make it to the hospital — despite coming from lower-income neighborhoods — their odds of dying are similar to or lower than white patients. Meanwhile, we also know that Black and Hispanic people are disproportionately contracting and dying of COVID-19 across the country."
The findings indicate other structural factors such as poor housing conditions and unequal healthcare access may contribute to the higher numbers of out-of-hospital deaths in Hispanic and Black communities, and should be considered in future research, the study said.