@article {Chaudhary897, author = {Siddique Chaudhary and Sadia Benzaquen and Jessica G Woo and Jack Rubinstein and Atul Matta and Jeri Albano and Robert De Joy III and Kevin Bryan Lo and Gabriel Patarroyo-Aponte}, title = {Clinical Characteristics, Respiratory Mechanics, and Outcomes in Critically Ill Individuals With COVID-19 Infection in an Underserved Urban Population}, volume = {66}, number = {6}, pages = {897--908}, year = {2021}, doi = {10.4187/respcare.08319}, publisher = {Respiratory Care}, abstract = {BACKGROUND: The COVID-19 outbreak in the United States has disproportionately affected Black individuals, but little is known about the factors that underlie this observation. Herein, we describe these associations with mortality in a largely minority underserved population.METHODS: This single-center retrospective observational study included all adult subjects with laboratory-confirmed SARS-Cov-2 treated in our ICU between March 15 and May 10, 2020.RESULTS: 128 critically ill adult subjects were included in the study (median age 68 y [interquartile range 61{\textendash}76], 45\% female, and 64\% Black); 124 (97\%) required intubation. Eighty (63\%) subjects died during their in-patient stay, which did not differ by race/ethnicity. Compared with other racial/ethnic groups, Blacks had a greater proportion of women (52\% vs 30\%, P = .02) and subjects with hypertension (91\% vs 78\%, P = .035). Asthma (P = .03) was associated with lower in-patient death, primarily among Black subjects (P = .02). Among Black subjects, increased age (odds ratio 1.06 [95\% CI 1.05{\textendash}1.22] per year), positive fluid balance (odds ratio 1.06 [95\% CI 1.01{\textendash}1.11] per 100 mL), and treatment with tocilizumab (odds ratio 25.0 [95\% CI 3.5{\textendash}180]) were independently associated with in-patient death, while higher platelets (odds ratio 0.65 [95\% CI 0.47{\textendash}0.89] per 50 {\texttimes} 103/mL) and treatment with intermediate dose anticoagulants (odds ratio 0.08 [95\% CI 0.02{\textendash}0.43]) were protective. Among other race/ethnic groups, higher total bilirubin (odds ratio 1.75 [95\% CI 0.94{\textendash}3.25] per 0.2 mg/dL) and higher maximum lactate (odds ratio 1.43 [95\% CI 0.96{\textendash}2.13] per mmol/L) were marginally associated with increased death, while tocilizumab treatment was marginally protective (odds ratio 0.24 [95\% CI 0.05{\textendash}1.25]). During first 72 h of ventilation, those who died had less increase in (P = .046) and less reduction in PEEP (P = .01) and requirement (P = .002); these patterns did not differ by race/ethnicity.CONCLUSIONS: Black and other race/ethnicity subjects had similar mortality rates due to COVID-19 but differed in factors that were associated with increased risk of death. In both groups, subjects who died were older, had a positive fluid balance, and less improvement in , PEEP, and requirement on ventilation.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/66/6/897}, eprint = {https://rc.rcjournal.com/content/66/6/897.full.pdf}, journal = {Respiratory Care} }