Abstract 17491: Abstract

Introduction: Mortality and demographic data during the COVID-19 pandemic demonstrate a disproportionate prevalence and mortality among patients identifying as Black and Native American. Hypothesis: We hypothesized minority patients would have worse COVID-19 outcomes and be less likely to receive COVID-19 specific therapies compared to Caucasian patients. Methods: We used the Michigan Medicine COVID-19 Cohort to extract treatment and outcome data on adult patients with COVID-19 who had been discharged or died by June 17 th , 2020. We calculated crude rates of COVID-19 specific treatments and outcomes between patients identifying in different racial groups using Caucasian patients as a baseline. Results: Of 553 patients analyzed, 486 patients were included, 213 (43.8%) identified as Caucasian, 232 (47.7%) identified as Black, 33 (6.8%) identified as Asian, 6 (1.2%) had an unknown racial group, and 1 identified as more than one race and 1 identified as Native American. Given this distribution, analysis was focused on Black and Caucasian patients. Black patients were less likely to receive remdesivir (3.9% vs 12.2%, P-value = 0.001) or be enrolled in COVID-19 clinical trials (10.3% vs 19.7%, P-value = 0.005). Black patients were more likely than Caucasian patients to have acute kidney injury (63.8% vs 45.5%, P-value = <0.001) and need renal replacement therapy (20.3% vs 9.9%, P-value = 0.002). No significant differences were noted in mortality, ARDS, need for renal replacement therapy at discharge, or length of stay. Conclusions: Racial disparities exist in both treatment and outcomes in COVID-19. We report a stark difference in the rate of receipt of remdesivir between Black and Caucasian patients and lower Black patient enrollment in clinical trials, matching trends in other areas of medicine. Further study is needed to determine if these differences in treatment are associated with the differential renal outcomes seen, and how comorbidities impact outcomes.