The study, published in the journal Radiology, provides further evidence on racial/ethnic disparities in COVID-19 severity among patients on admission.
The researchers analysed data from 326 patients with COVID-19 who were hospitalised between March 27 and April 10, 2020, and after examining the chest X-rays, it became clear that people who were not white were more likely to have severe cases of COVID-19, as indicated by the X-ray.
The researchers at the Massachusetts General Hospital, in Boston, found that non-White patients admitted with confirmed COVID-19 infection were more likely to present with increased disease severity, as measured by modified Radiographic Assessment of Lung Edema score (adjusted average difference=1.6, p<0.01).
The researchers led by Nicholas Joseph also found that “higher mRALE scores were associated with an increased likelihood of adverse composite clinical outcomes for White/Non-Hispanic (Adjusted HR=1.3, p<0.001) and Non-White patients (Adjusted HR=1.2, p<0.001).
“Increased radiographic severity among Non-White patients was associated with delayed presentation, low English proficiency, and obesity,” they said.
The researchers also noted that the results of this study are consistent with emerging data that show racial/ethnic minorities have been disproportionately affected by COVID-19.
“The study results show that Non-White patients had significantly greater delays in presentation after the onset of symptoms.
“This could be due to a variety of complex socio-demographic factors that disproportionately affect racial/ethnic minority patients, including employment in low-wage occupations with limited sick-leave and an inability to work remotely, such as in the service industry, living in overcrowded multigenerational households within high population-density metropolitan areas, higher dependence on public transportation, medical mistrust and racial stigma experienced in the health system, among others.
“These delays in presentation likely result in missing a critical window of early treatment that may be related to the increased disease severity at the time of presentation.”
They added that the high incidence of this highly transmissible virus in crowded metropolitan areas, higher prevalence of medical co-morbidities associated with worse outcomes, such as obesity, and the association with employment that is incompatible with remote work are factors that place racial/ethnic minority patients at increased risk of infection, more severe clinical presentation, and worse outcomes.