COVID-19 among African Americans and Hispanics: Does gastrointestinal symptoms impact the outcome?

Hassan Ashktorab, Adeleye Folake, Antonio Pizuorno, Gholamreza Oskrochi, Philip Oppong-Twene, Nuri Tamanna, Maryam Mehdipour Dalivand, Lisa N. Umeh, Esther S. Moon, Abdoul Madjid Kone, Abigail Banson, Cassandra Federman, Edward Ramos, Eyitope Ola Awoyemi, Boubini Jones Wonni, Eric Otto, Guttu Maskalo, Alexandra Ogando Velez, Sheldon Rankine, Camelita ThriftChiamaka Ekwunazu, Derek Scholes, Lakshmi Gayathri Chirumamilla, Mohd Elmugtaba Ibrahim, Brianna Mitchell, Jillian Ross, Julencia Curtis, Rachel Kim, Chandler Gilliard, Joseph Mathew, Adeyinka Laiyemo, Angesum Kibreab, Edward Lee, Zaki Sherif, Babak Shokrani, Farshad Aduli, Hassan Brim

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND The coronavirus disease 2019 (COVID-19) disproportionately affected African Americans (AA) and Hispanics (HSP). AIM To analyze the significant effectors of outcome in African American patient population and make special emphasis on gastrointestinal (GI) symptoms, laboratory values and comorbidities METHODS We retrospectively evaluated the medical records of 386 COVID-19 positive patients admitted at Howard University Hospital between March and May 2020. We assessed the symptoms, including the GI manifestations, comorbidities, and mortality, using logistic regression analysis. RESULTS Of these 386 COVID-19 positive patients, 257 (63.7%) were AAs, 102 (25.3%) HSP, and 26 (6.45%) Whites. There were 257 (63.7%) AA, 102 (25.3%) HSP, 26 (6.45%) Whites. The mean age was 55.6 years (SD = 18.5). However, the mean age of HSP was the lowest (43.7 years vs 61.2 for Whites vs 60 for AAs). The mortality rate was highest among the AAs (20.6%) and lowest among HSP (6.9%). Patients with shortness of breath (SOB) (OR2 = 3.64, CI = 1.73-7.65) and elevated AST (OR2 = 8.01, CI = 3.79-16.9) elevated Procalcitonin (OR2 = 8.27, CI = 3.95-17.3), AST (OR2 = 8.01, CI = 3.79-16.9), ferritin (OR2 = 2.69, CI = 1.24-5.82), and Lymphopenia (OR2 = 2.77, CI = 1.41-5.45) had a high mortality rate. Cough and fever were common but unrelated to the outcome. Hypertension and diabetes mellitus were the most common comorbidities. Glucocorticoid treatment was associated with higher mortality (OR2 = 5.40, CI = 2.72-10.7). Diarrhea was prevalent (18.8%), and GI symptoms did not affect the outcome. CONCLUSION African Americans in our study had the highest mortality as they consisted of an older population and comorbidities. Age is the most important factor along with SOB in determining the mortality rate. Overall, elevated liver enzymes, ferritin, procalcitonin and C-reactive protein were associated with poor prognosis. GI symptoms did not affect the outcome. Glucocorticoids should be used judiciously, considering the poor outcomes associated with it.

Original languageEnglish (US)
Pages (from-to)8374-8387
Number of pages14
JournalWorld Journal of Clinical Cases
Volume9
Issue number28
DOIs
StatePublished - 2021
Externally publishedYes

Keywords

  • African Americans
  • COVID-19
  • Gastrointestinal manifestation
  • Hispanics
  • Liver
  • Pandemic

ASJC Scopus subject areas

  • General Medicine

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