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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
COVID-19 among African Americans and Hispanics: Does gastrointestinal symptoms impact the outcome?
Hassan Ashktorab, Adeleye Folake, Antonio Pizuorno, Gholamreza Oskrochi, Philip Oppong-Twene, Nuri Tamanna, Maryam Mehdipour Dalivand, Lisa N Umeh, Esther S Moon, Abdoul Madjid Kone, Abigail Banson, Cassandra Federman, Edward Ramos, Eyitope Ola Awoyemi, Boubini Jones Wonni, Eric Otto, Guttu Maskalo, Alexandra Ogando Velez, Sheldon Rankine, Camelita Thrift, Chiamaka Ekwunazu, Derek Scholes, Lakshmi Gayathri Chirumamilla, Mohd Elmugtaba Ibrahim, Brianna Mitchell, Jillian Ross, Julencia Curtis, Rachel Kim, Chandler Gilliard, Joseph Mathew, Adeyinka Laiyemo, Angesum Kibreab, Edward Lee, Zaki Sherif, Babak Shokrani, Farshad Aduli, Hassan Brim
Hassan Ashktorab, Adeleye Folake, Philip Oppong-Twene, Nuri Tamanna, Maryam Mehdipour Dalivand, Lisa N Umeh, Esther S Moon, Abdoul Madjid Kone, Abigail Banson, Cassandra Federman, Edward Ramos, Eyitope Ola Awoyemi, Boubini Jones Wonni, Eric Otto, Guttu Maskalo, Alexandra Ogando Velez, Sheldon Rankine, Camelita Thrift, Chiamaka Ekwunazu, Derek Scholes, Lakshmi Gayathri Chirumamilla, Mohd Elmugtaba Ibrahim, Brianna Mitchell, Jillian Ross, Julencia Curtis, Rachel Kim, Chandler Gilliard, Joseph Mathew, Adeyinka Laiyemo, Angesum Kibreab, Edward Lee, Zaki Sherif, Babak Shokrani, Farshad Aduli, Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, Washington, DC 20060, United States
Antonio Pizuorno, Faculty of Medicine, La Universidad del Zulia, Maracaibo 4002, Zulia, Venezuela
Gholamreza Oskrochi, College of Engineering and Technology, American University of Middle East Kuwait, Egaila 54200, Kuwait
Zaki Sherif, Department of Biochemistry and Molecular Biology, Howard University College of Medicine, Washington, DC 20060, United States
Hassan Brim, Pathology and Cancer Center, Department of Biochemistry and Molecular Biology, Howard University College of Medicine, Washington, DC 20060, United States
Author contributions: Ashktorab H contributed to study concept and design; Ashktorab H and Brim H wrote the paper; Pizuorno A, Brim H, Folake A, Oppong-Twene P, Tamanna N, Ibrahim ME, Umeh LN, Moon ES, Kone AM, Banson A, Federman C, Ramos E, Awoyemi EO, Wonni BJ, Otto E, Maskalo G, Velez AO, Rankine S, Ekwunazu C, Mathew J, ER, Scholes D, Kibrea A, Shokrani B, Sherif Z, Dalivand MM, Chirumamilla LG, Mitchell B, Ross J, Curtis J, Kim R, Gilliard C, Aduli F, Thrift C, Laiyemo A, Kibreab A and Lee E collected and analyzed the clinical data; Oskrochi G performed statistical analysis; Ashktorab H obtained the funding; Ashktorab H and Brim H contributed to material support; all authors evaluated the manuscript for intellectual content and approved the manuscript.
Supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health, No. G12MD007597.
Institutional review board statement: This study was approved and reviewed by Howard University Hospital Institutional Review Board (No: The Howard University IRB Federal Wide Assurance number is FWA00000891).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used de-identified data clinical data that were obtained after each patient agreed to treatment by written consent
Conflict-of-interest statement: The authors declare that there is no conflict of interest regarding the publication of this paper.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Hassan Ashktorab, PhD, Professor, Department of Medicine, Gastroenterology Division and Cancer Center, Howard University College of Medicine, 2041 Georgia Avenue, N.W., Washington, DC 20060, United States. hashktorab@howard.edu
Received: June 12, 2021
Peer-review started: June 12, 2021
First decision: July 18, 2021
Revised: July 19, 2021
Accepted: August 18, 2021
Article in press: August 18, 2021
Published online: October 6, 2021
ARTICLE HIGHLIGHTS
Research background
The coronavirus disease 2019 (COVID-19) disproportionately affected African Americans and Hispanics. The United States has one of the most diverse populations, exhibiting discrepancies in healthcare access, socioeconomic status, and wealth distribution, all of which lead to disparities in health outcomes across different groups, especially in minorities.
Research motivation
To evaluate the clinical manifestations, comorbidities, and laboratory parameters in COVID-19 patients and identify risk factors that may be related to poor prognosis.
Research objectives
To clarity whether clinical manifestations and laboratory parameters are related to the prognosis of COVID-19 positive African American (AA) patients.
Research methods
This study is a retrospective analysis. Patient demographics, symptoms, underlying comorbidities, treatment, and outcomes were compared among AA, Caucasians, Hispanics, and other ethnic groups. Predictors of hospital mortality evaluated by using logistic and/or multiple logistic regression. SPSS version 26 (SPSS Inc., Chicago, IL, United States) was used for this analysis.
Research results
A total of 386 COVID-19 positive patients, 257 (63.7%) were AAs, 102 (25.3%) Hispanics, and 26 (6.45%) Whites. The mortality rate was highest among the AAs (20.6%) and lowest among Hispanics (6.9%). Patients with shortness of breath (OR2 = 3.64, CI = 1.73-7.65) and elevated AST (OR2 = 8.01, CI = 3.79-16.9) elevated Procalcitonin (OR2 = 8.27, CI = 3.95-17.3), AST (OR2 = 8.01, CI = 3.79-16.9), ferritin (OR2 = 2.69, CI = 1.24-5.82), and Lymphopenia (OR2 = 2.77, CI = 1.41-5.45) had a high mortality rate. Glucocorticoid treatment was associated with higher mortality (OR2 = 5.40, CI = 2.72-10.7)
Research conclusions
The African Americans were the most affected population due to severe acute respiratory syndrome coronavirus 2 in our study with high mortality. Predictors of poor outcomes in our study are Age > 50, shortness of breath, increased liver enzymes, CRP, Ferritin, Procalcitonin. Injudicious use of glucocorticoids resulted in poor outcomes. The presence of gastrointestinal symptoms did not increase disease severity.
Research perspectives
In the future, we will continue to follow COVID-19 positive patients to analyze the causes of death and the risk factors that may lead to death. And we will devote ourselves to finding predictors related to the prognosis of minority patients with COVID-19.
