key: cord-0861698-m2g6qdsf
authors: Agrawal, Manasi; Brenner, Erica J.; Yan Mak, Joyce Wing; Zhang, Xian; Kaplan, Gilaad G.; Ng, Siew C.; Reinisch, Walter; Steinwurz, Flavio; Lewis, James D.; Kissous-Hunt, Michele; Modesto, Irene; Ungaro, Ryan C.; Colombel, Jean-Frederic; Kappelman, Michael D.
title: COVID-19 outcomes among racial and ethnic minority individuals with inflammatory bowel disease in the United States
date: 2021-06-02
journal: Clin Gastroenterol Hepatol
DOI: 10.1016/j.cgh.2021.05.060
sha: efe87c49707a485de20829e0d54cdbd155ca7b12
doc_id: 861698
cord_uid: m2g6qdsf

nan

JWYM received research grants from Janssen Pharmaceuticals.

XZ reports no conflict of interest.

GGK has received honoraria for speaking or consultancy from Abbvie, Janssen, Pfizer, and 34 Takeda. He has received research support from Ferring, Janssen, Abbvie, GlaxoSmith Kline, 

Population characteristics

We evaluated 2,019 US cases reported to SECURE-IBD, of which 161 (8.0%) were Hispanic, 20 211 (10.5%) were non-Hispanic Black, 1,502 (74.4%) were Non-Hispanic White, and 145 (7.2%) 21 were reported as unknown or another race/ethnicity. In the entire cohort, the mean age was 22 35.7 years, 52.1% were female, and 23.4% were obese. Other baseline characteristics are 23 described in Supplementary Table 1 .

Across race/ethnicity categories, minority groups had higher prevalence of obesity, active IBD, 26 and co-morbid conditions including diabetes, hypertension, and lung disease. There was no 27 difference across race/ethnicity categories in the proportion of patients on each IBD medication 28 type.

Associations between race, ethnicity, and COVID-19 outcomes among US IBD patients 31 Hospitalization occurred in 12.4% of Hispanic, 7.1% of non-Hispanic White, and 20.4% of non- 

In the first set of models, compared to non-Hispanic White individuals, Hispanic individuals had 37 an increased risk of hospitalization (adjusted odds ratio [aOR] 2.70, 95% CI 1.56 to 4.66, 38 p=0.0004) and severe COVID-19 (aOR 3.04, 95% CI 1.09 to 8.49, p=0.03). (Figure) . After 39 additional adjustment for comorbidities, region, and IBD medications, the effect estimates were 

Effect estimates were similar without adjustment for IBD medications in otherwise identical 6 models.

We report that Hispanic and Black individuals had higher odds of hospitalization and severe 10 COVID-19 compared to non-Hispanic White individuals. Upon adjusting for comorbid conditions, 11 region, and IBD medications, the effect estimates, while slightly attenuated, remained significant 12 for hospitalization in both groups, and for severe COVID-19 among Black individuals.

Underlying comorbid conditions in both groups partially explain these findings, and are 

In summary, we highlight disparities in COVID-19 outcomes in IBD patients based on race and 30 ethnicity, mediated in part by comorbid conditions. These findings underscore the clinical 31 importance of considering social determinants of health and higher risk in minority groups.

Ultimately, health policies are needed to bridge these gaps and improve healthcare access and 33 outcomes for all. 

COVID-19 Dashboard by the Center for 2

Evidence mounts on the disproportionate effect of COVID-19 on ethnic 5 minorities

Effects of Race and Ethnicity on Diagnosis 7 and Management of Inflammatory Bowel Diseases

Hospitalization and Mortality among Black 12 Patients and White Patients with Covid-19

The major genetic risk factor for severe COVID-19 is inherited from

Racial/Ethnic Variation in Nasal Gene Expression