Table 4: Factors associated with mortality in African Americans and Caucasians.
|
Variables |
African Americans
|
Caucasians
|
||||
|
Alive N = 196 (%) |
Dead N = 52 (%) |
P-value |
Alive N = 102 (%) |
Dead N = 29 (%) |
P-value |
|
|
Demographic |
|
|
|
|
|
|
|
Age in yr (Mean ± SD) |
60.8 ± 13.8 |
72.6 ± 11.8 |
< 0.001 |
64.3 ± 15 |
78 ± 11.4 |
< 0.001 |
|
Comorbidities |
|
|
|
|
|
|
|
COPD |
15 (7.7) |
11 (21.2) |
0.01 |
21 (20.6) |
5 (17.2) |
0.893 |
|
CKD |
32 (16.3) |
17 (32.7) |
0.015 |
12 (11.8) |
9 (31) |
0.027 |
|
Diabetes mellitus |
76 (38.8) |
29 (55.8) |
0.041 |
38 (37.3) |
10 (34.5) |
0.956 |
|
Congestive Heart failure |
25 (12.8) |
13 (25) |
0.05 |
9 (8.8) |
7 (24.1) |
0.057 |
|
Home medication |
|
|
|
|
|
|
|
NSAID |
73 (37.2) |
23 (44.2) |
0.448 |
30 (29.4) |
15 (51.7) |
0.044 |
|
Statins |
69 (35.2) |
28 (53.8) |
0.022 |
29 (28.4) |
11 (37.9) |
0.452 |
|
Beta-blockers |
52 (26.5) |
14 (26.9) |
1 |
16 (15.7) |
14 (48.3) |
0.001 |
|
Clinical presentation |
|
|
|
|
|
|
|
Cough |
106 (54.1) |
31 (59.6) |
0.578 |
67 (65.7) |
8 (27.6) |
0.001 |
|
Altered mental status |
24 (12.2) |
18 (34.6) |
< 0.001 |
14 (13.7) |
16 (55.2) |
< 0.001 |
|
Respiratory support |
|
|
|
|
|
|
|
BiPAP |
12 (6.1) |
6 (11.5) |
0.299 |
3 (2.9) |
6 (20.7) |
0.004 |
|
Mechanical ventilation |
24 (12.2) |
34 (65.4) |
< 0.001 |
13 (12.7) |
10 (34.5 |
0.015 |
|
Vasopressor |
8 (4.1) |
19 (36.5) |
< 0.001 |
3 (2.9) |
6 (20.7) |
0.004 |
|
Laboratory results |
|
|
|
|
|
|
|
WBC/µL (Mean ± SD) |
7707 ± 3672 |
8689 ± 5212 |
0.121 |
7319 ± 3508 |
9762 ± 6236 |
0.007 |
|
Neutrophil/µL (Mean ± SD) |
5617 ± 3107 |
7058 ± 4640 |
0.009 |
5191 ± 2813 |
7332 ± 4493 |
0.002 |
|
Lymphocyte/µL (Mean ± SD) |
1186 ± 571 |
818 ± 476 |
< 0.001 |
1141 ± 756 |
993 ± 599 |
0.333 |
|
AST (Units/L, Mean ± SD) |
45.1 ± 39.3 |
265.3 ± 812 |
< 0.001 |
38.5 ± 34.3 |
238 ± 794 |
0.015 |
|
ALT (Units/L, Mean ± SD) |
31.8 ± 30.9 |
251.2 ± 904 |
0.001 |
29.7 ± 28.4 |
357 ± 1593 |
0.045 |
|
Bilirubin > 1.2 mg/dL |
12 (6.1) |
12 (23.1) |
0.001 |
6 (5.9) |
4 (13.8) |
0.208 |
|
Lung Involvement Severity Score (Mean ± SD) |
2.84 ± 3.7 |
4.4 ± 2.4 |
0.005 |
2.29 ± 1.8 |
3.2 ± 2.3 |
0.022 |
|
Length of hospitalization (Mean ± SD) |
8.88 ± 8.6 |
12.6 ± 8.7 |
0.007 |
9.19 ± 8.3 |
9.3 ± 5.5 |
0.939 |
|
COVID-19 treatment |
|
|
|
|
|
|
|
Hydroxychloroquine |
87 (44.4) |
28 (53.8) |
0.289 |
46 (45.1) |
4 (13.8) |
0.004 |
|
Azithromycin |
101 (51.5) |
37 (71.2) |
0.018 |
49 (48) |
11 (37.9) |
0.452 |
|
Steroid |
18 (9.2) |
13 (25) |
0.005 |
15 (14.7) |
5 (17.2) |
0.966 |
|
IV antibiotics |
|
|
|
|
|
|
|
Vancomycin |
34 (17.3) |
22 (42.3) |
< 0.001 |
16 (15.7) |
17 (58.6) |
< 0.001 |
|
Cefepime |
27 (13.8) |
19 (36.5) |
< 0.001 |
20 (19.6) |
15 (51.7) |
0.001 |
|
Inflammatory markers |
|
|
|
|
|
|
|
C-reactive protein (mg/dL, Mean ± SD) |
8.5 ± 9.1 |
16.7 ± 13.4 |
< 0.001 |
6 ± 7 |
12.4 ± 10 |
< 0.001 |
|
Ferritin (ng/mL, Mean ± SD) |
1519.5 ± 4326 |
2683 ± 4803 |
0.106 |
539 ± 733 |
2799 ± 7618 |
0.007 |
|
Procalcitonin (ng/mL, Mean ± SD) |
0.41 ± 1.1 |
6.3 ± 14.1 |
< 0.001 |
3.78 ± 32.6 |
5 ± 18.7 |
0.858 |
|
D-dimer (µg/mL, Mean ± SD) |
1.69 ± 3.5 |
4.9 ± 7 |
< 0.001 |
6 ± 38.8 |
4.3 ± 5.1 |
0.863 |
In both African Americans and Caucasians, those who died were significantly older (P < 0.01), had higher rate of CKD (P < 005) and higher rate of mental status change at presentation (P < 0.001). In both races, those who died had higher neutrophil count (P < 0.01), elevated AST (P < 0.05), elevated ALT (P < 0.05), higher CRP values (P < 0.01) and higher lung involvement severity score (P < 0.05). The proportion of patients who received vancomycin or cefepime was higher among those who died compared to those who survived (P < 0.01).
In addition, African Americans who died had significantly higher rates of COPD (P < 0.05), diabetes mellitus (P < 0.05), congestive heart failure (P < 0.05), statin use (P < 0.05), azithromycin use (P < 0.05), steroid use (P < 0.01), increased length of hospitalization (P < 0.01) and higher prolactin and D-dimer levels (P < 0.01). Caucasians who died had significantly higher rates of use NSAID (P < 0.05) and beta-blocker (P < 0.01), increased total white blood cell count (P < 0.01), and higher prolactin values (P < 0.01). African American who survived had higher lymphocyte count compared to those who died (P < 0.01). In Caucasians, cough at presentation and use of hydroxychloroquine were more common in those who survived with P values of 0.001 and 0.004, respectively.