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Socioeconomic Factors Add to Risk for COVID-19 Positivity

MONDAY, March 29, 2021 -- Black race and Hispanic ethnicity are associated with increased odds of COVID-19 positivity, although the association is substantially mediated by socioeconomic factors, according to a study published online March 16 in the Annals of the American Thoracic Society.

Hayley B. Gershengorn, M.D., from University of Miami Miller School of Medicine, and colleagues evaluated whether socioeconomic factors mediate the association of race/ethnicity with COVID-19 incidence and outcomes. The analysis included 15,473 adults tested for COVID-19 (cohort 1) and 295 patients hospitalized with COVID-19 (cohort 2) between March 1 and July 23, 2020, at the University of Miami Hospital and Clinics.

The researchers found that among those tested, 8.1 percent of adults were COVID-19-positive, and among those hospitalized, 15.9 percent of patients died. Compared with non-Hispanic White individuals, other race/ethnicity was associated with test positivity (adjusted odds ratios, 3.21, 2.72, and 3.55 for non-Hispanic Black, Hispanic White, and Hispanic Black, respectively). These associations were mediated by population density (percent mediated: 17 percent), median income (27 percent), and household size (20 percent). The study was underpowered, and the investigators were unable to fully evaluate associations between race/ethnicity and mortality.

"Even if too late for COVID-19, improvements in the social situations of all patients living in more crowded, less well-off communities may pay dividends for their health when the next pandemic, or the next season of influenza, hits," the authors write.

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