Outcomes in patients hospitalized for COVID-19 among Asian, Pacific Islander, and Hispanic subgroups in the American Heart Association COVID-19 registry

Background

Coronavirus disease 2019 (COVID-19) data from race/ethnic subgroups remain limited, potentially masking subgroup-level heterogeneity. We evaluated differences in outcomes in Asian American/Pacific Islander (AAPI) and Hispanic/Latino subgroups compared with non-Hispanic White patients hospitalized with COVID-19.

Methods

In the American Heart Association COVID-19 registry including 105 US hospitals, mortality and major adverse cardiovascular events in adults age ≥18 years hospitalized with COVID-19 between March-November 2020 were evaluated. Race/ethnicity groups included AAPI overall and subgroups (Chinese, Asian Indian, Vietnamese, and Pacific Islander), Hispanic/Latino overall and subgroups (Mexican, Puerto Rican), compared with non-Hispanic White (NHW).

Results

Among 13,511 patients, 7% were identified as AAPI (of whom 17% were identified as Chinese, 9% Asian Indian, 8% Pacific Islander, and 7% Vietnamese); 35% as Hispanic (of whom 15% were identified as Mexican and 1% Puerto Rican); and 59% as NHW. Mean [SD] age at hospitalization was lower in Asian Indian (60.4 [17.4] years), Pacific Islander (49.4 [16.7] years), and Mexican patients (57.4 [16.9] years), compared with NHW patients (66.9 [17.3] years, p<0.01). Mean age at death was lower in Mexican (67.7 [15.5] years) compared with NHW patients (75.5 [13.5] years, p<0.01). No differences in odds of mortality or MACE in AAPI or Hispanic patients relative to NHW patients were observed after adjustment for age.

Conclusions

Pacific Islander, Asian Indian, and Mexican patients hospitalized with COVID-19 in the AHA registry were significantly younger than NHW patients. COVID-19 infection leading to hospitalization may disproportionately burden some younger AAPI and Hispanic subgroups in the US.