Blacks and Asians are four times more likely to die from Covid

Blacks, Asians and Hispanics who are hospitalized with Covid are four times more likely to die than their Caucasian counterparts, according to a new international study by cardiologists at the University of Cape Town (UCT). The main predictors of mortality were older age, over 60, male, pre-existing coronary artery disease, diabetes, renal failure, severe covid infection with a higher respiratory rate and requiring hospitalization in an intensive care unit and oxygen. Patients from low-income, lower-middle, and upper-middle income countries were at significantly greater risk of mortality than high-income countries. Professor Karen Sliva is one of the principal investigators of the study and director of Heart Cape…

Blacks, Asians and Hispanics who are hospitalized with Covid are four times more likely to die than their Caucasian counterparts, according to a new international study by cardiologists at the University of Cape Town (UCT).

The main predictors of mortality were older age, over 60, male, pre-existing coronary artery disease, diabetes, kidney disease, severe covid infection with a higher respiratory rate and requiring hospitalization in an intensive care unit and oxygen.

Patients from low-income, lower-middle, and upper-middle income countries were at significantly greater risk of mortality than high-income countries.

Professor Karen Sliva — one of the study’s principal investigators and director of the Cape Heart Institute in UCT’s Department of Health Sciences — says the study represents the first comprehensive global data on mortality, cardiovascular outcomes and cardiovascular risk factors among hospitalized Covid patients recruited from different segments of the population.

The researchers found that HIV status was positively associated with 30-day mortality, but not with hospital mortality, suggesting a differentiated immune response, such as a lower likelihood of a cytokine storm during acute illness, but other sensitive factors combined. with health system factors influencing the increase in 30-day mortality.

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Forty hospitals from 23 countries, including South Africa, recruited 5,313 Covid patients for the study, and the team collected data on demographics and pre-existing medical conditions at hospital admission, clinical outcomes at hospital discharge (death, serious adverse cardiovascular events, renal failure, neurological events). and pulmonary outcomes), 30-day vital status and readmission.

This is the first global study that examines the relationship of hospital-level resources and country income status to clinical outcomes, with data on hospital-level resources and facilities collected from each participating hospital.

Dr. Glenda Davison, Associate Professor and Chair of Biomedical Sciences at the Cape Peninsula University of Technology, said the study, published in the Global Heart Journal, is significant because it included patients from hospitals around the world.

Lack of resources

She said that the fact that low-income countries had higher rates of hospitalized deaths was not too surprising and could be explained by the lack of resources and medical personnel in these countries.

Davison said another reason could be low vaccination rates in many low-income countries, adding that vaccinations reduce the severity of Covid, hospitalizations and deaths, and this will be affected by unequal distribution. She said finding the risk of death among Asians, blacks and Hispanics was important, especially in South Africa with such a diverse population.

Pre-existing comorbidities may be an explanation, but in many cases, especially in Africa, these often go undiagnosed and therefore patients do not receive proper treatment.

“An article published in South African Medical Journal in 2012… showed that in the mixed-race community in Cape Town, the incidence of prediabetes and diabetes is 28%, which is much higher than in other populations,” Davison said.

She said it is also well known that Africans are more likely to suffer from hypertension, many of which are undiagnosed, unmanaged and untreated.

Davison said the study is very important not only for how to deal with Covid, but also for diagnosing and treating underlying comorbidities.

Dr Jo Barnes, an epidemiologist at Stellenbosch University, said it was good that the official study confirmed what has been the subject of discussion among many healthcare professionals caring for hospitalized Covid patients.

She said that when interpreting these results, one should keep in mind that in many countries in the northern hemisphere where such studies are often conducted, the vulnerable groups identified in this study were often first or second generation immigrants.

Barnes said many of the observations were made in the US or Europe, and a significant proportion of such immigrants were also in the lower end of the income range.

“Nutrition, access to health care, the quality of safe housing, safe neighborhoods and employment status are determined by income levels and at the same time are factors influencing resistance to infectious diseases.”

However, Barnes said that, according to the general discussion of links, the link between severe Covid effects and belonging to interest groups persists even when low income has been offset.

She said the exact genetic basis for such associations is being investigated, but the links are likely to be complex.

– siphom@citizen.co.za