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The Critically Ill Without COVID-19 Infection During the COVID-19 Pandemic: an Analysis of Race and Ethnicity at an Urban Safety-Net Hospital

Abstract

Purpose

This investigation sought to compare admissions, length of stay, and mortality among medical intensive care unit (MICU) patients without coronavirus disease 2019 (COVID-19) infection admitted to an urban safety-net hospital during the pandemic by patients’ self-identified race and ethnicity.

Materials and Methods

We conducted a retrospective observational study comparing MICU admissions before and during the first surge of COVID-19 illness at an urban, safety-net hospital in Minneapolis, Minnesota.

Results

MICU admissions declined from a pre-pandemic average of 968 to 761 during the first COVID surge, including 627 patients (82%) without COVID-19 infection. MICU mortality among patients without COVID-19 infection during the pandemic was 12.8% compared to 9.6% in the pre-pandemic period (p = 0.045). However, rates of non-COVID-19 MICU admissions, mortality, volume, and length of stay did not differ by race and ethnicity between time periods. Of the 131 MICU admissions with COVID-19 infection, patients were more frequently Hispanic ethnicity (24%) or Black (40%), and less frequently White (22%) compared to the pre-pandemic cohort (7%, 30%, and 48%, respectively [p < 0.001]).

Conclusions

During the first COVID-19 surge, MICU admissions for non-COVID-19 disease decreased from pre-pandemic levels, but these patients experienced greater mortality. Unlike critically ill patients admitted with COVID-19 infection, admissions and hospital mortality did not differ by race and ethnicity compared to the pre-pandemic period.

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Data Availability

Data is housed in VDW affiliated with Hennepin Healthcare.

Code Availability

Not applicable.

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Funding

This investigator-initiated work was internally funded by the Hennepin Healthcare Department of Medicine (Minneapolis, MN).

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Authors and Affiliations

Authors

Contributions

All authors contributed to the study conception and design. Material preparation was performed by Michael Downey, Matthew Prekker, and Robert Kempainen. Data collection and analysis were performed by Madison Hoover. The first draft of the manuscript was written by Michael Downey and Robert Kempainen. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Robert R. Kempainen.

Ethics declarations

Ethics Approval

The study was approved by the Hennepin Healthcare Research Institute Internal Review Board with a full waiver of informed consent under approval number: IRB-FY2021-114.

Consent to Participate

The study was approved by the Hennepin Healthcare Research Institute Internal Review Board with a full waiver of informed consent under approval number: IRB-FY2021-114.

Consent for Publication

Not applicable — no individual patient data was presented as part of publication.

Conflict of Interest

The authors declare no competing interests.

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Downey, M.C., Hoover, M.R., Prekker, M.E. et al. The Critically Ill Without COVID-19 Infection During the COVID-19 Pandemic: an Analysis of Race and Ethnicity at an Urban Safety-Net Hospital. J. Racial and Ethnic Health Disparities (2022). https://doi.org/10.1007/s40615-022-01361-z

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  • DOI: https://doi.org/10.1007/s40615-022-01361-z

Keywords

  • COVID-19
  • Healthcare disparities
  • Intensive care
  • Mortality