Increased COVID-19 infection rates, morbidity and mortality among African Americans?

3,427 Views | 18 Replies | Last: 5 yr ago by Aust Ag
Marcus Aurelius
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7:33p, 4/6/20
AG
I have been reading about this. Anecdotally my first hand experience is similar. They seem to do worse. I practice in the Deep South. CDC hasn't published anything yet but they need to get this data available. Reasons? Complex. But I suspect increased obesity, DM, HTN etc. Other socioeconomic reasons? As clinicians we need to brace for potential worsened clinical courses in these pts.

https://www.salon.com/2020/04/06/data-suggests-covid-19-deaths-disproportionately-hit-african-american-communities_partner/

I know this isn't a reputable "scientific" website but it is a pretty good review.
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HeardAboutPerio
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7:49p, 4/6/20
AG
Some paradoxical thoughts Not related at all to proposed reason discussed above for higher incidence of morbidity amongst blacks:

The sickle cell trait (7.3% of African Americans) affords some protection against malaria, and plaquenil is a possible Beneficial therapy for covid19 used to treat malaria... somewhat ironic on a superficial level without fully understanding the pathogenesis of Covid19. I wonder if those that Are positive for sickle cell trait are also less likely to have severe cases of covid19?
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Keegan99
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In reply to Marcus Aurelius • 8:29p, 4/6/20
AG
I would think the impact of socioeconomic factors on living environments plays a role in transmission rates among certain communities.
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Gizzards
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In reply to Marcus Aurelius • 8:34p, 4/6/20
AG
Interesting if it turns out to be true, but what could you do differently based on this? We still need to treat patients based on their actual symptomatology.
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Marcus Aurelius
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8:37p, 4/6/20
AG
IDK. But. Anectodally it's real. Scary.
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TAMU1990
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8:40p, 4/6/20
AG
Isn't this also a function of minorities being clustered in metro areas? Detroit, Milwaukee, and New Orleans have a large percentage of black residents.
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pocketrockets06
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In reply to Gizzards • 8:54p, 4/6/20
AG
Among other things, one of the factors that is likely at play in the higher case load and fatality rates among black patients is the possibility of undiagnosed or undertreated complicating factors like diabetes, hypertension, etc.

So maybe treating those patients more aggressively (not sure what that would be for this particular disease) or maybe doing some additional screening to make sure they are prescribed a fresh supply of BP meds, insulin, etc if they are going to isolate at home? Not a doctor but these would be my thoughts.
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TXTransplant
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9:13p, 4/6/20
I've seen similar stories recently about pregnancy complications and maternal deaths among AA women.

https://www.npr.org/2017/12/07/568948782/black-mothers-keep-dying-after-giving-birth-shalon-irvings-story-explains-why

Part of the explanation is that these women often do have underlying conditions that either aren't recognized or aren't taken seriously.
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Gizzards
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In reply to pocketrockets06 • 9:34p, 4/6/20
AG
My question is rhetorical. There really is nothing that information will change. It's no different than the propensity for men to apparently fare worse with this virus. You still have to treat the patient based on their clinical presentation. This type of information is more helpful in dealing with and screening for chronic diseases such as diabetes heart disease, and cancer.
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Federale01
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In reply to Keegan99 • 10:36p, 4/6/20
AG
Not only living environments, but the type of jobs they do. In my area, most public transportation workers, grocery workers, etc, are African American. Most people who can telework are in white collar jobs, which tends to be a whiter cohort on average. Many AAs can't take off or work from home.

That doesn't explain a higher mortality rate, but definitely would factor in to a higher infection rate.
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CashinOut
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In reply to Marcus Aurelius • 10:42p, 4/6/20
AG
What's the likelihood of untested/unknown sickle cell in this population being hit hard?
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Keegan99
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10:53p, 4/6/20
AG
What percentage of senior citizen African Americans live with children and/or grandchildren? How does that metric compare with other demographics?

Multigenerational living arrangements was a factor that negatively impacted Italy.
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Marcus Aurelius
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10:55p, 4/6/20
AG
Great ? re concomitant sickle dz....
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zag80
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10:57p, 4/6/20
AG
Governor Edwards said in his briefing today that over 70% of Louisiana's COVID deaths were African-American. Startling number.
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Federale01
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11:28p, 4/6/20
AG
It will be interesting to watch the breakdown between two racially different counties that surround common cities. For example, Montgomery County Maryland and Prince George's County Maryland. One is predominantly white and one is predominantly AA and they surround Washington DC. They should track the same, actually Montgomery County is more populated and should have more cases. But PG has a greater number of cases and deaths. I wonder if other similar locations have similar patterns.
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DTP02
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In reply to zag80 • 10:13a, 4/7/20
AG
zag80 said:
Governor Edwards said in his briefing today that over 70% of Louisiana's COVID deaths were African-American. Startling number.


Probably less startling than any other statistic for COVID deaths. New Orleans is the epicenter and is 60% black. Add in a cultural trend toward multi-generational living arrangements for elderly, that population density is going to boost transmission, and a higher rate of obesity and diabetes among that population, and it's almost surprising it's not higher.
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Cancelled
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11:17a, 4/7/20
Perhaps african americans are more likely to reside in urban areas and urban areas are hit more? Was this controlled for?
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Complete Idiot
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In reply to zag80 • 11:27a, 4/7/20
zag80 said:
Governor Edwards said in his briefing today that over 70% of Louisiana's COVID deaths were African-American. Startling number.
I'm not sure where the hotspots are in the state, but my belief was mostly in New Orleans. New Orleans is 60% African America so the number wouldn't be too startling by itself. The fear for any community that is financially poor, and most of New Orleans AA population unfortunately falls into that bucket, is that they have undiagnosed medical conditions, as mentioned above, and that they can't afford to isolate themselves.
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Sonic5678
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2:42p, 4/7/20
AG
So sad.
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Aust Ag
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In reply to pocketrockets06 • 5:57p, 4/7/20
AG
pocketrockets06 said:
Among other things, one of the factors that is likely at play in the higher case load and fatality rates among black patients is the possibility of undiagnosed or undertreated complicating factors like diabetes, hypertension, etc.

So maybe treating those patients more aggressively (not sure what that would be for this particular disease) or maybe doing some additional screening to make sure they are prescribed a fresh supply of BP meds, insulin, etc if they are going to isolate at home? Not a doctor but these would be my thoughts.
Saw an interview with Dr. Ben Carson today, he said what the poster above said in 1st paragraph.
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