COVID-19 Scan for Jul 17, 2020

Racial disparities in COVID chest x-rays
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COVID-19 risk factors

Ethnic minorities have more severe COVID-19 chest x-rays findings

Racial and ethnic minorities are more likely to have evidence of severe COVID-19 disease on chest x-rays, according to a study yesterday in Radiology.

The study was based on 326 patients hospitalized with confirmed COVID-19 infection between Mar 27 and Apr 10, seen by radiologists at Massachusetts General Hospital (MGH). Doctors at the hospital noticed non-white patients had significant more lung disease on admitting chest x-rays than white patients and studied the phenomenon.

The study that found non-white patients admitted with confirmed COVID-19 infection were more likely to have signs of more severe disease on admission chest radiographs, as measured by the radiographic assessment of lung (mRALE) score (adjusted average difference, 1.6)

The study authors said the severe disease progression was likely because non-white patient accessed healthcare later in their illnesses.

"Many of these patients delay their care because they're considered essential workers and they don't have a lot of sick leave, but also it's difficult for them to leave because they are living on a weekly paycheck and have other dependents," said study coauthor Efren J. Flores, MD, a radiologist at MGH in a press release. "It wasn't uncommon for us to go into the medical record when we were interpreting their exams and see that many of them worked at grocery stores or warehouses."
Jul 16 Radiology study
Jul 16 Radiological Society of North America
press release

 

Age remains key risk factor for COVID-19 ICU admission, study shows

A study today in Clinical Infectious Diseases reiterates that advanced age is a main risk factor for intensive care unit admission (ICU) among US patients hospitalized for COVID-19 infections.

The study, based on 2,491 adults hospitalized with laboratory-confirmed COVID-19 from Mar 1 to May 2 through the Coronavirus Disease 2019-Associated Hospitalization Surveillance Network (COVID-NET), showed that risk for severe COVID-19 was raised over the ages of 50 to 64, 65 to 74, 75 to 84 and older than 85 years, versus 18 to 39 years (adjusted risk ratio [aRR] 1.53, 1.65, 1.84 and 1.43, respectively).

Ninety-two percent of all hospitalized patients had one or more underlying condition, and 32% with underlying conditions required ICU admission. Nineteen percent required mechanical ventilation, and 17% died.

Men were more likely than women to suffer severe COVID-19 infections, and the most significant comorbidities were immunosuppression (aRR, 1.39), renal disease (1.33), chronic lung disease (1.31), cardiovascular disease (1.28), neurologic disorders (1.25), and diabetes (1.19).

"In our study, age ≥65 years was the strongest independent predictor of ICU admission and in-hospital mortality," the authors concluded. "Persons aged 75–84 years had the highest the risk of ICU admission compared to 18-49 years old, and those ≥85 years experienced 11 times the risk of death. These findings are similar to other studies from China, Europe, and the United States."
Jul 16 Clin Infect Dis
study

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