Black, Hispanic patients with lupus have worse COVID-19 outcomes than white patients
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Black and Hispanic patients with systemic lupus erythematous demonstrate more severe COVID-19 outcomes than white patients, according to data published in Arthritis Care & Research.
The researchers added that these findings “likely reflect,” and highlight a need to address, socioeconomic and health disparities between these patient populations.
“During the COVID-19 pandemic, many existing health disparities have been exacerbated in vulnerable populations who are more likely to have high-risk exposures, poor access to health care, and inequitable treatment,” Manuel F. Ugarte-Gil, MD, MSc, of the Universidad Cientifica del Sur, in Lima, Peru, and colleagues wrote. “Although COVID-19 outcomes in people with SLE have been reported, differential outcomes by race and ethnicity in this vulnerable population have not been comprehensively assessed.”
To investigate the association between race and ethnicity and COVID-19 outcomes in patients with SLE, Ugarte-Gil and colleagues analyzed data from the COVID-19 Global Rheumatology Alliance (GRA) registry. The researchers collected data on patients with SLE who were enrolled in the registry between March 12, 2020, and Aug. 27, 2021.
Each patients’ race and ethnicity data were recorded and entered into the database by the reporting physician. Multiple responses from a number of options could be selected, including Arab, African American, East Asian, South Asian, West Asian/Middle Eastern, Pacific Islander, Latin American, white, Native American/Aboriginal/First Nations, other, unknown, or prefer not to answer. For the current study, the researchers categorized these groups into white, Black, Hispanic or other and mixed-race individuals. In addition, the white population was used as the reference group.
The researchers analyzed outcome severity using the following parameters: patient not hospitalized, patient hospitalized with no oxygen, patient hospitalized with any ventilation or oxygen, or death. For each patient, only the highest severity level of the outcome that occurred during their disease course was included. Additionally, all patients were required to have a resolved their clinical course, which meant that the final outcome of their COVID-19 infection was recorded, the researchers wrote.
The analysis included 523 patients, of whom 358 patients were not hospitalized while 40 were hospitalized with no oxygen, 64 were hospitalized with oxygen or ventilation, and 18 died. According to the researchers, Black (OR = 2.73; 95% CI, 1.36-5.53) and Hispanic (OR = 2.76; 95% CI, 1.34-5.69) patients demonstrate higher chances of experiencing more severe outcomes compared with white patients.
Black race and Hispanic ethnicity were associated with more severe COVID-19 outcomes among SLE patients entered in the COVID-19 GRA registry,” Ugarte-Gil and colleagues wrote. “These results likely reflect health disparities that are at least in part mediated by social determinants of health. Achieving equitable health outcomes for socially disadvantaged SLE populations is likely to require the implementation of public health measures that directly address social disparities and mitigate social disadvantage.”
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