Characterization of Hospitalized COVID-19 Patients in Georgia

One in four hospitalized COVID-19 patients had no underlying high-risk conditions, and racial disparities were significant.

Understanding the demographics and outcomes of those requiring hospitalization for SARS-CoV-2 infection, the cause of COVID-19, informs efforts to prevent further spread of the disease. To characterize COVID-19 in the state of Georgia, investigators abstracted data from charts of 305 COVID-19 patients hospitalized at eight hospitals during March of 2020.

Although the median age was 60 years, age was <65 years in 62% of patients, and 26% lacked an underlying condition known to place them at high risk. Overall, 39% of patients were admitted to intensive care. Excluding the 24 patients (8%) still hospitalized as of the analysis, 17% died, including 5% of those without high-risk conditions. Of the 97% of patients with data on race/ethnicity, 83% were non-Hispanic Black (NHB). Four hospitals contributed two-thirds of total patients; 80% of their COVID-19 cohort was NHB, compared with 47% of their overall hospitalized patients. NHB patients did not differ from non-NHB patients in receipt of invasive mechanical ventilation or mortality, nor were NHB patients more likely to have common high-risk conditions, including diabetes, cardiovascular disease, chronic lung disease, or severe obesity.

Comment

This case series has two striking findings. First, persons of all ages, including those without high-risk conditions, remain at risk for severe SARS-CoV-2 infection. Second, the overrepresentation of NHB in this cohort is jarring and suggests increased risk for acquiring infection. These findings should guide prevention messages, but the racial disparities should prompt further evaluation and thoughtful intervention. In Georgia, as in many regions, the downstream effects of structural racism limit opportunities for NHB people to optimize social distancing and self-isolation. Ignoring these challenges risks worsening existing healthcare disparities and ongoing epidemic spread.

Reviewing Author

Wendy S. Armstrong, MD

Disclosures

Consultant/Advisory BoardNIH Therapeutics and Prevention Data Safety Monitoring Board

Leadership Positions in Professional SocietiesAmerican Board of Internal Medicine Infectious Diseases Subspecialty Board (member), Infectious Diseases Society of America (Vice President)