Association of race/ethnicity and socioeconomic status with COVID-19 30-day mortality at a Philadelphia medical center using a retrospective cohort study.

Cheney-Peters, Dianna R; Crystal Y Lee M P H,; Mitsuhashi, Shuji; Zaret, Dina S; Riley, Joshua M; Venkataraman, Chantel M; Schaefer, Joseph W; George, Brandon J; Li, Chris J; Smaltz, Christa M; Bradley, Conor G; Fitzpatrick, Danielle M; Ney, David B; Chalikonda, Divya M; Mairose, Joshua D; Chauhan, Kashyap; Szot, Margaret V; Jones, Robert B; Bashir-Hamidu, Rukaiya; Kubey, Alan A

OBJECTIVE COVID-19 has disproportionately affected low-income communities and people of color. Previous studies demonstrated that race/ethnicity and socioeconomic status (SES) are not independently correlated with COVID-19 mortality. The purpose of our study is to determine the effect of race/ethnicity and SES on COVID-19 30-day mortality in a diverse, Philadelphian population. METHODS This is a retrospective cohort study in a single center tertiary care hospital in Philadelphia, PA. The study includes adult patients hospitalized with polymerase-chain-reaction-confirmed COVID-19 between March 1st , 2020 and June 6th , 2020. The primary outcome was a composite of COVID-19 death or hospice discharge within 30 days of discharge. The secondary outcome was intensive care unit (ICU) admission. RESULTS The study included 426 patients. 16.7% died, 3.3% were discharged to hospice, and 20.0% were admitted to the ICU. Using multivariable analysis, race/ethnicity was not associated with the primary nor secondary outcome. In Model 4, age greater than 75 (Odds Ratio [OR], 11.01; 95% confidence interval [CI], 1.96 to 61.97) and renal disease (OR 2.78; 95% CI, 1.31 to 5.90) were associated with higher odds of the composite primary outcome. "Very-low-income area" (OR 0.29; 95% CI, 0.12 to 0.71) and BMI 30-35 (OR 0.24; 95% CI, 0.08 to 0.69) were associated with lower odds of the primary outcome. CONCLUSIONS When controlling for demographics, SES, and comorbidities, race/ethnicity was not independently associated with the composite primary outcome. Very-low SES, as extrapolated from census-tract-level income data, were associated with lower odds of the composite primary outcome. This article is protected by copyright. All rights reserved.