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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



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.


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]).


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.


  1. Tai DBG, Shah A, Doubeni CA, et al. The disproportionate impact of COVID-19 on racial and ethnic minorities in the United States. Clin Infect Dis. 2021;72:705–8.

    CAS  Article  Google Scholar 

  2. Smulowitz PB, O’Malley AJ, Khidir H, et al. National trends in ED visits, hospital admissions, and mortality for medicare patients during the COVID-19 pandemic. Health Aff (Millwood). 2021;40:1457–64.

    Article  Google Scholar 

  3. Birkmeyer JD, Barnato A, Birkmeyer N, et al. The impact of the COVID-19 pandemic on hospital admissions in the United States. Health Aff (Millwood). 2020;39:2010–7.

    Article  Google Scholar 

  4. Lyall M, Lone NI. Higher clinical acuity and 7-day hospital mortality in non-COVID-19 acute medical admissions: prospective observational study. Emerg Med J. 2021;38:366–70.

    Article  Google Scholar 

  5. Bodilsen J, Nielsen PB, Sogaard M, et al. Hospital admission and mortality rates for non-COVID-19 diseases in Denmark during covid-19 pandemic: nationwide population based cohort study. BMJ. 2021;373:n1135.

    Article  Google Scholar 

  6. Wadhera RK, Figueroa JF, Rodriguez F, et al. Racial and ethnic disparities in heart and cerebrovascular disease deaths during the COVID-19 pandemic in the United States. Circulation. 2021;143:2346–54.

    CAS  Article  Google Scholar 

  7. Marmarchi F, Liu M, Rangaraju S, et al. Clinical outcomes of critically ill patients with COVID-19 by race. J Racial Ethn Health Disparities. 2022;9:385–9.

    Article  PubMed  Google Scholar 

  8. Lopez DC, Whelan G, Kojima L, et al. Critical care among disadvantaged minority groups made equitable: trends throughout the COVID-19 pandemic. J Racial Ethn Health isparities. 2022;4:1–11.

    Article  Google Scholar 

  9. Hennepin Healthcare Community Profile. In: Hennepin Healthcare Community Health Needs Assessment 2019. 2019. Accessed 6 March 2022.

  10. Williams DR, Cooper LA. Covid-19 and health equity — a new kind of “herd immunity.” JAMA. 2020;323:2478–80.

    CAS  Article  Google Scholar 

  11. Bologheaunu R, Maleczek M, Laxar D, et al. Outcomes of non-Covid-19 critically ill patients during the COVID-19 pandemic: a retrospective propensity score-matched analysis. Wien Klin Wochenschr. 2021;133:942–50.

    Article  Google Scholar 

  12. Zampieri FG, Bastos LSL, Soares M, et al. The association of the COVID-19 pandemic and short-term outcomes of non-COVID-19 critically ill patients: an observational cohort study in Brazilian ICUs. Intensive Care Med. 2021;47:1440–9.

    CAS  Article  Google Scholar 

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

Author information

Authors and Affiliations



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).

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