NEW YORK — Since the start of the COVID emergency in America, health officials have warned communities of color about their higher vulnerability to the virus. In a surprising discovery, researchers in New York say Blacks and Hispanics are actually less likely to have a severe illness or die from COVID-19 once they reach the hospital compared to White patients.
Investigators from New York University focused on patient records from over 9,700 people tested for COVID-19 across the NYU Langone Health system. Those records come from March 1, 2020 to April 8, 2020 and followed patients until May 13, 2020. The New York City area was one of the original hot spots for the virus in the United States during this time.
“We know that Black and Hispanic populations account for a disproportionate share of COVID-19–related deaths relative to their population size in New York and major cities across the country,” says study lead author Gbenga Ogedegbe, MD, MPH, in a university release.
“We were, however, surprised to find that Black and Hispanic patients were no more likely to be hospitalized across NYU Langone than white patients, which means we need to look at other structural factors at play that are negatively affecting outcomes in these communities. These factors include poor housing conditions, unequal access to healthcare, differential employment opportunities, and poverty—and they must be addressed.”
Does COVID have a smaller racial disparity than many believe?
The results reveal 4,843 patients tested positive for coronavirus during the study. Of that group, 39 percent were White, 25.9 percent Hispanic, 15.7 percent Black, seven percent Asian, and another 7.4 percent identified as multiracial or other. More than half of the patients (2,623) went into the hospital due to their condition.
Of these hospitalizations, the demographics were nearly unchanged, with 39.9 percent White, 27.3 percent Hispanic, 14.3 percent Black, and 6.9 percent Asian. The greatest commonality between these hospitalized COVID patients was that they were older with a higher chance of death from disease.
Luckily, over 70 percent of the patients entering the hospital would eventually be discharged. More than a third experienced a severe COVID-19 infection and 24.7 percent of the group tragically died of the virus. Just under five percent were still in the hospital at the end of the study on May 13.
After examining all these outcomes, the NYU team finds hospitalized Blacks and Hispanics had a lower chance of developing a severe infection or dying than Whites. After taking age, sex, insurance status, and other health issues into account, hospitalized Blacks continued to have a lower risk of death from COVID than their White peers.
Asian patients actually displayed higher odds of needing hospitalization than Whites, even though they are less likely to receive a positive COVID test.
Social factors influencing the pandemic
“Our findings provide more evidence that the social determinants of health play a critical role in determining patient outcomes, particularly for Black patients, before they ever get to the hospital,” says NYU Langone’s Joseph E. Ravenell, MD.
“However, we do see a bit of a paradox. 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 doctors add Black communities are more likely to have insufficient or no health insurance at all compared to whites. Researchers say this makes people of color more likely to die at home than in a hospital.
Another factor the team is looking at is the differences between men and women. The study says hospitalized men fare worse than women dealing with COVID-19. In this study, 62 percent of the hospitalized Black patients were female.
The study appears in JAMA Network Open.