Racial and ethnic differences in COVID-19-associated septic shock

Table 1 Baseline characteristics of patients between Non-Hispanic Black and Non-Hispanic White, n (%)

Variables	Non-Hispanic White (n = 227315)	Non-Hispanic Black (n = 76875)	Total (n = 304190)	P value
Female	87930 (38.68)	39075 (50.83)	128680 (42.30)	< 0.001
Age (years)	67.29 ± 14.35	63.07 ± 14.85	66.23 ± 14.59
< 65	87930 (38.68)	39075 (50.83)	127005 (41.75)	< 0.001
≥ 65	139385 (61.32)	37800 (49.17)	177185 (58.25)
Hospital bed size				0.2709
Small	51915 (22.84)	16650 (21.66)	68565 (22.54)
Medium	67930 (29.88)	22270 (28.97)	90200 (29.65)
Large	107470 (47.28)	37955 (49.37)	145425 (47.81)
Hospital teaching status				< 0.001
Rural	22925 (10.09)	3425 (4.46)	26350 (8.66)
Urban non-teaching	47590 (20.94)	12135 (15.79)	59725 (19.63)
Urban teaching	156800 (68.98)	61315 (79.76)	218115 (71.70)
Elective admission	5105 (2.25)	1210 (1.57)	6315 (2.08)	< 0.001
Primary payment coverage				< 0.001
Medicare	138045 (60.73)	41240 (53.65)	179285 (58.94)
Medicaid	18935 (8.33)	12380 (16.10)	31315 (10.29)
Private insurance	56095 (24.68)	17715 (23.04)	73810 (24.26)
Self-pay	4835 (2.13)	2300 (2.99)	7135 (2.35)
No charge	245 (0.11)	230 (0.30)	475 (0.16)
Other	9160 (4.03)	3010 (3.92)	12170 (4.00)
Median household income ($)				< 0.001
1-28999	65355 (28.75)	38495 (50.07)	103850 (34.14)
29000-35999	64670 (28.45)	17525 (22.80)	82195 (27.02)
36000-46999	55860 (24.57)	13045 (16.97)	68905 (22.65)
47000+	41430 (18.23)	7810 (10.16)	49240 (16.19)
Hospital region				< 0.001
Northeast	38145 (16.78)	12205 (15.88)	50350 (16.55)
Midwest	52215 (22.97)	13235 (17.22)	65450 (21.52)
South	100390 (44.16)	45090 (58.65)	145480 (47.83)
West	36565 (16.09)	6345 (8.25)	42910 (14.11)
Comorbidities
Congestive heart failure	58415 (25.70)	20920 (27.21)	79335 (26.08)	< 0.001
Atrial fibrillation	49580 (21.81)	10900 (14.18)	60480 (19.88)	< 0.001
Coronary artery disease	47560 (20.92)	10835 (14.09)	58395 (19.20)	< 0.001
Peripheral vascular disease	14040 (6.18)	3995 (5.20)	18035 (5.93)	< 0.001
Hypertension	148215 (65.20)	56665 (73.71)	204880 (67.35)	< 0.001
Hyperlipidemia	91575 (40.29)	27740 (36.08)	119315 (39.22)	< 0.001
Chronic lung disease	60615 (26.67)	17440 (22.69)	78055 (25.66)	< 0.001
Diabetes	89885 (39.54)	39590 (51.50)	129475 (42.56)	< 0.001
Chronic kidney disease	56795 (24.99)	27745 (36.09)	84540 (27.79)	< 0.001
Liver disease	25965 (11.42)	9445 (12.29)	35410 (11.64)	0.0085
Anemia	10740 (4.72)	5445 (7.08)	16185 (5.32)	< 0.001
Acquired immunodeficiency syndrome	320 (0.14)	600 (0.78)	920 (0.30)	< 0.001
Cancer	11860 (5.22)	3520 (4.58)	15380 (5.06)	0.0024
Coagulopathy	56165 (24.71)	20635 (26.84)	76800 (25.25)	0.0002
Obesity	67125 (29.53)	25965 (33.78)	93090 (30.60)	< 0.001
Smoking	15605 (6.86)	5170 (6.73)	20775 (6.83)	0.5673
Elixhauser comorbidity score	4.94 ± 2.13	5.20 ± 2.15	5.01 ± 2.14	< 0.001

Table 2 Baseline characteristics of patients between Hispanics and Non-Hispanic White, n (%)

Variables	Non-Hispanic White (n = 227315)	Hispanic (n = 92575)	Total (n = 319890)	P value
Female	91825 (40.40)	34565 (37.34)	126390 (39.51)	< 0.001
Age	67.29 ± 14.35	60.43 ± 15.75	65.31 (15.09)	< 0.001
Age (years)
< 65	87930 (38.68)	53645 (57.95)	141575 (44.26)
≥ 65	139385 (61.32)	38930 (42.05)	178315 (55.74)	< 0.001
Hospital bed size				0.1466
Small	51915 (22.84)	19140 (20.68)	71055 (22.21)
Medium	67930 (29.88)	27985 (30.23)	95915 (29.98)
Large	107470 (47.28)	45450 (49.10)	152920 (47.80)
Hospital teaching status				< 0.001
Rural	22925 (10.09)	1560 (1.69)	24485 (7.65)
Urban non-teaching	47590 (20.94)	18615 (20.11)	66205 (20.70)
Urban teaching	156800 (68.98)	72400 (78.21)	229200 (71.65)
Elective admission	5105 (2.25)	1595 (1.72)	6700 (2.09)	0.0022
Primary payment coverage				< 0.001
Medicare	138045 (60.73)	36400 (39.32)	174445 (54.53)
Medicaid	18935 (8.33)	22225 (24.01)	41160 (12.87)
Private insurance	56095 (24.68)	23765 (25.67)	79860 (24.96)
Self-pay	4835 (2.13)	5985 (6.47)	10820 (3.38)
No charge	245 (0.11)	320 (0.35)	565 (0.18)
Other	9160 (4.03)	3880 (4.19)	13040 (4.08)
Median household income ($)				< 0.001
1-28999	65355 (28.75)	35125 (37.94)	100480 (31.41)
29000-35999	64670 (28.45)	24320 (26.27)	88990 (27.82)
36000-46999	55860 (24.57)	21695 (23.44)	77555 (24.24)
47000+	41430 (18.23)	11435 (12.35)	52865 (16.53)
Hospital region				< 0.001
Northeast	38145 (16.78)	11755 (12.70)	49900 (15.60)
Midwest	52215 (22.97)	5905 (6.38)	58120 (18.17)
South	100390 (44.16)	35410 (38.25)	135800 (42.45)
West	36565 (16.09)	39505 (42.67)	76070 (23.78)
Comorbidities
Congestive heart failure	58415 (25.70)	15545 (16.79)	73960 (23.12)	< 0.001
Atrial fibrillation	49580 (21.81)	12540 (13.55)	62120 (19.42)	< 0.001
Coronary artery disease	47560 (20.92)	10240 (11.06)	57800 (18.07)	< 0.001
Peripheral vascular disease	14040 (6.18)	3710 (4.01)	17750 (5.55)	< 0.001
Hypertension	148215 (65.20)	54455 (58.82)	202670 (63.36)	< 0.001
Hyperlipidemia	91575 (40.29)	31445 (33.97)	123020 (38.46)	< 0.001
Chronic lung disease	60615 (26.67)	13325 (14.39)	73940 (23.11)	< 0.001
Diabetes	89885 (39.54)	48485 (52.37)	138370 (43.26)	< 0.001
Chronic kidney disease	56795 (24.99)	20220 (21.84)	77015 (24.08)	< 0.001
Liver disease	25965 (11.42)	13545 (14.63)	39510 (12.35)	< 0.001
Anemia	10740 (4.72)	4595 (4.96)	15335 (4.79)	0.3018
Acquired immunodeficiency syndrome	320 (0.14)	260 (0.28)	580 (0.18)	0.0002
Cancer	11860 (5.22)	2800 (3.02)	14660 (4.58)	< 0.001
Coagulopathy	56165 (24.71)	26200 (28.30)	82365 (25.75)	< 0.001
Obesity	67125 (29.53)	32040 (34.61)	99165 (31.00)	< 0.001
Smoking	15605 (6.86)	3585 (3.87)	19190 (6.00)	< 0.001
Elixhauser comorbidity score	4.94 ± 2.133768	4.50 ± 2.13	4.81 ± 2.14	< 0.001
Elixhauser comorbidity score ≥ 4	167790 (73.81)	61775 (66.73)	229565 (71.76)	< 0.001

Table 3 In-hospital events/outcomes between Non-Hispanic Black and Non-Hispanic White, n (%)

Variables	Non-Hispanic White (n = 227315)	Non-Hispanic Black (n = 76875)	Total (n = 304190)	P value	Adjusted odds ratio1 (95%CI)	P value
In-hospital mortality	106620 (46.90)	35455 (46.12)	142075 (46.71)	0.2342	0.97 (0.92-1.02)	0.198
Mechanical ventilation	114560 (50.40)	43060 (56.01)	157620 (51.82)	< 0.001	1.15 (1.09-1.22)	< 0.001
AKI	144530 (63.58)	55230 (71.84)	199760 (65.67)	< 0.001	1.39 (1.32-1.46)	< 0.001
AKI requiring dialysis	23090 (10.16)	13690 (17.81)	36780 (12.09)	< 0.001	1.65 (1.54-1.76)	< 0.001
Cost of hospitalization	50702.65 ± 68069.31	58955.7 ± 75763.08	52790.8 ± 70187.56	< 0.001	-	-
Length of stay	14.40 ± 14.17	16.63 ± 16.40	14.97 ± 14.80	< 0.001	-	-

¹Adjusted for age, female, hospital teaching status, elective admission, insurance type, median household income, hospital region, congestive heart failure, hypertension, diabetes, anemia, cancer, chronic pulmonary disease, chronic kidney disease, liver disease, human immunodeficiency virus, obesity, alcohol use, drug use, depression.

AKI: Acute kidney injury.

Table 4 In-hospital events/outcomes between Hispanics and Non-Hispanic White, n (%)

Variables	Non-Hispanic White (n = 227315)	Hispanic (n = 92575)	Total (n = 319890)	P value	Adjusted odds ratio1 (95%CI)	P value
In-hospital mortality	106620 (46.90)	46410 (50.13)	153030 (47.84)	< 0.001	1.21 (1.15-1.27)	< 0.001
Mechanical ventilation	114560 (50.40)	53420 (57.70)	167980 (52.51)	< 0.001	1.19 (1.12-1.27)	< 0.001
AKI	144530 (63.58)	54675 (59.06)	199205 (62.27)	< 0.001	0.85 (0.81-0.90)	< 0.001
AKI requiring dialysis	23090 (10.16)	12245 (13.23)	35335 (11.05)	< 0.001	1.16 (1.07-1.25)	< 0.001
Cost of hospitalization	50702.65 ± 68069.29	80980.45 ± 105075.2	59469.76 ± 81714.79	< 0.001
Length of stay	14.40 ± 14.17	19.21 ± 19.31	15.80 ± 15.98	< 0.001

¹Adjusted for age, female, hospital teaching status, elective admission, insurance type, median household income, hospital region, congestive heart failure, hypertension, diabetes, cancer, chronic pulmonary disease, chronic kidney disease, liver disease, human immunodeficiency virus, obesity, alcohol use, drug use, depression, smoking.

AKI: Acute kidney injury.