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\begin{document}

\title{Is There a Racial Disparity in Coronavirus Disease 2019 Patients with
Chronic Kidney Disease? An Experience in New York City}



\author[1]{Takayuki Yamada}%
\author[1]{Takahisa Mikami}%
\author[1]{Nitin Chopra}%
\author[1]{Hirotaka Miyashita}%
\author[1]{Svetlana Chernyavsky}%
\author[1]{Satoshi Miyashita}%
\affil[1]{Mount Sinai Beth Israel Hospital}%


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  \date{May 20, 2024}


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Dear Editor,

Since December 2019, coronavirus 2019 (COVID-19) has spread
worldwide.\textsuperscript{1} Some data have suggested that the
prevalence and mortality of COVID-19 are different among races.
\textsuperscript{2}However, this analysis did not account for potential
confounding factors.

Since chronic kidney disease (CKD) is common, the number of COVID-19
patients with CKD will increase. However, there are scarce data about
outcomes in CKD patients. We herein investigated the outcomes from
COVID-19 in AAs compared to those in whites.

We analyzed Mount Sinai Health System (MSHS) medical records up to April
5, 2020, using Epic SlicerDicer software. We extracted data from
patients who had positive for the COVID-19 reverse-transcription
polymerase chain reaction (RT-PCR) test. Sex, age, race, and
comorbidities (hypertension, diabetes mellitus, ischemic heart disease,
heart failure, and atrial fibrillation) were extracted using the 10th
revision of the International Statistical Classification of Diseases
code. Mortality and intensive care unit (ICU) admission were tracked
through April 12, 2020. Relative risks (RR) and 95 \% confidence
interval (CI) in each race stratified by age groups and comorbidities
were calculated using a Fisher's exact test. MSHS waived Institutional
Review Board approval since this research used only deidentified,
aggregate-level data.

During the study period, 1,269 AAs COVID-19 patients with 105 CKD
patients and 1,450 whites COVID-19 patients with 80 CKD patients were
detected. AAs were younger (median 66, IQR 55-76) than whites (median
75, IQR 65-83) (p\textless{} 0.001). There was no significant difference
in mortality between AAs and whites (0.65 {[}0.36-1.15{]}). This
tendency was observed after stratification by age and medical
conditions. Similarly, AAs did not have an increased risk of ICU
admission (0.84 {[}0.6-1.18{]})) even after stratification by age and
comorbidities (Table).

To the best of our knowledge, this is the first study that compared the
risk of severe outcomes among races in CKD patients. Although it has
been suggested that there might be racial disparity in COVID-19, our
study did not show any significant differences in outcomes, even after
stratifying patients by age and comorbidities. Our data suggested that
we do not need to stratify these patients by race.

The racial and ethnic diversity in NYC enabled us to investigate
differences in outcomes among races in the same cohort. However, our
study has several limitations. First, the number of patients was
relatively small. Second, we did not access individual data, which
prevented us from performing multivariate analyses. The fact that AAs
were younger might mask differences among races.

In conclusion, AAs with CKD did not have a higher risk of mortality or
ICU admission than whites with CKD. This trend was consistent after
stratification by age, sex, or comorbidities.

Acknowledgements: none

Conflict of Interest Disclosures: TY reports no conflict of interest. TM
reports no conflict of interest. NC reports no conflict of interest. HM
reports no conflict of interest. SC repots no conflict of interest. SM
reports no conflict of interest.

Reference

1. Team CC-R. Preliminary Estimates of the Prevalence of Selected
Underlying Health Conditions Among Patients with Coronavirus Disease
2019 - United States, February 12-March 28, 2020. \emph{MMWR Morb Mortal
Wkly Rep.} 2020;69(13):382-386.

2. Health N. Age adjusted rate of fatal lab confirmed COVID-19 cases per
100,000 by race/ethnicity group as of April 6, 2020 (Accessed Aprio 12,
2020). 2020.

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