COVID-19: in a young US cohort, social disparities are linked to risk

  • Bailey LC & al.
  • JAMA Pediatr
  • 23.11.2020

  • von Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • In a large US cohort (n=135,794) of younger patients (age 
  • Social disparities related to risk were identified.

Why this matters

  • Little is known about COVID-19 epidemiology in younger US patients.
  • Social disparities seem to be present across age groups.

Study design

  • SARS-CoV-2 testing was routinely performed on all admissions to PEDSnet, a network of 7 US health systems serving 6.5 million patients in 11 states. 
  • From January 1 to September 8, 2020, there were 135,794 patients age
  • Funding: Patient-Centered Outcomes Research Institute.

Key results

  • Of the 135,794 patients, 4% tested positive.
  • COVID-19 in 7% of positive patients met a broad definition of severe illness.
  • The case fatality rate was 0.2%.
  • Risk factors associated with infection included increasing age, having coverage by a public payer, and being Hispanic, Black, or of Asian ancestry.
  • Despite lower rates of testing vs Whites, positive test results were more likely (aORs; 95% CIs) for patients who were:
    • Black: 2.66 (2.43-2.90).
    • Hispanic: 3.75 (3.39-4.15).
    • Of Asian ancestry: 2.04 (1.69-2.48).
  • Positive test results were more likely observed with a variety of conditions, including cardiac, endocrinological, genetic, and metabolic disorders (using standardized ratios).

Limitations

  • Electronic health records were used.
  • Retrospective, observational design.