Ethnic Disparities in COVID-19 among Older Adults Presenting to the Geriatric Emergency Department

Shadyab, Aladdin H.; Castillo, Edward M.; Brennan, Jesse J.; Chan, Theodore C.; Tolia, Vaishal M.

BACKGROUND: There is a dearth of epidemiological data on ethnic disparities among older COVID-19 patients. OBJECTIVE: The objective of this study was to characterize ethnic differences in clinical presentation and outcomes from COVID-19 among older U.S. adults. METHODS: This was a retrospective cohort study within two geriatric emergency departments (GEDs) at a large academic health system. 100 patients ≥65 years who visited a GED between March 10, 2020 and August 9, 2020 and tested positive for COVID-19 were examined. Electronic medical records were used to determine presenting COVID-19-related symptoms, comorbidities, and clinical outcomes. Descriptive statistics are reported with associated 95% confidence intervals (CI). RESULTS: In the overall sample, mean age was 75.9 years; 18% were ≥85 years; 50% were male; and 46.0% were Hispanic. Relative to non-Hispanic patients with COVID-19, Hispanic patients with COVID-19 had a higher percentage of shortness of breath (78.3% vs. 51.9%; difference: 26.4% [95% CI: 7.6%-42.5%]), pneumonia (82.6% vs. 50.0%; difference: 32.6% [95% CI: 14.1%-47.9%]), acute respiratory distress syndrome (13.0% vs. 1.9%; difference: 11.1% [95% CI: 0.7%-23.9%]), and acute kidney failure (41.3% vs. 22.2%; difference: 19.1% [95% CI: 0.9%-36.0%]). Rates of poor outcomes including hospitalization, ICU admission, return visits to the GED within 30 days of discharge, or death did not significantly differ between Hispanic and non-Hispanic COVID-19 patients. CONCLUSION: These preliminary data show that older Hispanic relative to non-Hispanic COVID-19 patients presenting to a GED did not experience worse outcomes including hospitalization, ICU admission, 30-day return visits to the GED, or death.