Racial Disparity and Temporal Patterns in Time to Invasive Ventilation During the COVID-19 Pandemic (Jan 2020 to Feb 2022)

Abstract · Background: The COVID-19 pandemic has significantly stressed the healthcare system since January 2020. There are questions whether there were racial disparities in the use of resources and procedures during this period and if so, did the disparities change over the pandemic. We focus on invasive ventilation (Mechanical Ventilation/MV and Extracorporeal Membrane Oxygenation/ECMO) and racial identity of the patient for the pre-Delta and Delta timeframes. · Methods: We used data available from the National COVID Cohort Collaborative (N3C) of COVID positive patients across the US. Cox regression models were used to estimate time to MV and ECMO as the dependent variables and race, age, gender, Comorbidity index as covariates. · Results: We did not find systematic patterns of racial disparity in time to MV. Asian and Hispanic patients, but not Black patients, received MV in a delayed manner compared to White patients in the pre-Delta period. These differences were not evident in the Delta period. · Conclusions: The results show a temporal change from the pre-Delta and Delta timeframes for the time to invasive ventilation implying that any observed racial disparities improved over time. We did not find statistically significant differences in the time to ECMO across the races or over timeframes.