Racial/Ethnic and Geo-clustering Differentials in SARS-CoV-2 (COVID-19) Cumulative Incidence, Mortality and Temporal Trend in Delaware State, USA

Main Article Content

Laurens Holmes Jr. Keerti Deepika Janille Williams Doriel Ward Benjamin Ogundele Chinacherem Chinaka Michael Enwere Osatohamwen Okundaye Tatiana Picolli Jennifer Thompson Maura Poleon Glen Philipcien Shikha Jain Naresh Dasari Ram Sanjiv Alur Ramesh Adhikari Gbadebo O Ogungbade

Abstract

Purpose: COVID-19, a respiratory disease caused by SARS-CoV-2 indicates subpopulation differentials in cumulative incidence (CmI) and mortality. We aimed to assess the racial/ethnic and geo-clustering in COVID-19 CmI and mortality in Delaware.


Method: A cross-sectional ecologic design was used to assess COVID-19 mortality in April, May and November 2020. The binomial and poison regression models were utilized for race/ethnic and geo-clustering risk prediction, respectively.


Results: As per late April, CmI remains to be flattened in DE, with the confirmed SARS-CoV-2, n=4575


(47.5 per 10,000), Sussex county (SC), n=2,114 (111.4 per 10,000), Kent county, n=728 (41.8 per


10,000) and New Castle county, n=1,701 (28.7 per 10,000). CmI was highest for Non-Hispanic blacks (NHB), 27% (n=1250) but lowest among Asian/Pacific Islanders, n=61 (1%). The disproportionate burden of COVID-19 CmI was highest among Hispanics, 100.2 per 10,000. COVID-19 cases were more prevalent among NHB (30%) and Hispanics (19%). Mortality was higher among NHB, 1.70 per 10,000 compared to Non-Hispanic whites (NHW), 1.34 per 10,000. COVID-19 mortality differed by race, with NHB relative to NHW 27% more likely to die, risk ratio (RR)=1.27, 95%CI, 0.85-1.89. Geo-clustering indicated a significant 50% increased mortality risk in SC compared to DE, incidence rate ratio


(IRR)=1.50, 95%CI, 1.11-2.03.During November, the case fatality rate (CFR) in DE was 27 per 10,000, while in the US, the CFR was 25 per 10,000.


Conclusions: The Delaware COVID-19 CmI indicates disproportionate burden on NHB and Hispanics; case clustering disproportionate burden in SC; and the risk of dying was highest among NHB.

Article Details

How to Cite
HOLMES JR., Laurens et al. Racial/Ethnic and Geo-clustering Differentials in SARS-CoV-2 (COVID-19) Cumulative Incidence, Mortality and Temporal Trend in Delaware State, USA. Medical Research Archives, [S.l.], v. 10, n. 6, june 2022. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2787>. Date accessed: 17 apr. 2024. doi: https://doi.org/10.18103/mra.v10i6.2787.
Section
Research Articles

References

1. Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD. How will country-based mitigation measures influence the course of the COVID-19 epidemic? The Lancet. 2020;395(10228):931-934. doi:10.1016/s0140-6736(20)30567-5
2. Ramphul K. Headache may not be linked with severity of coronavirus disease 2019 (COVID-19). World Journal of Emergency Medicine. 2020;11(4):274. doi:10.5847/wjem.j.1920-8642.2020.04.014
3. Emsworld.com. Published 2022. Accessed May 1, 2022.
https://www.emsworld.com/1224381/spotting-clottinghypercoagulopathy-covid-19
4. Bikdeli B, Madhavan MV, Jimenez D, et al. COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up. Journal of the American College of Cardiology. 2020;75(23). doi:10.1016/j.jacc.2020.04.031
5. OMRAN AR. The Epidemiologic Transition: A Theory of the Epidemiology of Population Change. Milbank Quarterly. 2005;83(4):731-757. doi:10.1111/j.1468-0009.2005.00398.x
6. McKeown RE. The Epidemiologic Transition: Changing Patterns of Mortality and Population Dynamics. American Journal of Lifestyle Medicine. 2009;3(1_suppl):19S26S. doi:10.1177/1559827609335350
7. Holmes L, Enwere M, Williams J, et al. Black–White Risk Differentials in COVID-19 (SARS-COV2) Transmission, Mortality and Case Fatality in the United States: Translational Epidemiologic Perspective and Challenges. International Journal of Environmental Research and Public Health. 2020;17(12):4322. doi:10.3390/ijerph17124322
8. Rothe C, Schunk M, Sothmann P, et al. Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. New England Journal of Medicine. 2020;382(10). doi:10.1056/nejmc2001468
9. Singhal T. A review of coronavirus disease-2019 (COVID-19). The Indian Journal of Pediatrics. 2020;87(4):281-286. doi:10.1007/s12098-020-03263-6
10. Mohanty SK, Satapathy A, Naidu MM, et al. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19) – anatomic pathology perspective on current knowledge. Diagnostic Pathology. 2020;15(1). doi:10.1186/s13000-020-01017-8
11. Applied Epidemiologic Principles and Concepts: Clinicians’ Guide to Study Design and Conduct. Routledge & CRC Press.
Applied Epidemiologic Principles and Concepts: Clinicians' Guide to Study Design and Conduct
12. – My Healthy Community – State of Delaware. myhealthycommunity.dhss.delaware.gov. Accessed May 1, 2022.
https://myhealthycommunity.dhss.delaware.gov/locations/stateAccessed
13. Gee GC, Ford CL. STRUCTURAL RACISM AND HEALTH INEQUITIES. Du Bois Review: Social Science Research on Race. 2011;8(1):115-132. doi:10.1017/s1742058x11000130
14. Krogstad JM, Gonzalez-Barrera A, Lopez MH. Hispanics more likely than Americans overall to see coronavirus as a major threat to health and finances. Pew Research Center. Accessed May 1, 2022.
https://www.pewresearch.org/fact-tank/2020/03/24/hispanics-more-likely-
15. Despres C. Update: Coronavirus Case Rates and Death Rates for Latinos in the United States. Salud America. Published March 1, 2022. https://salud-america.org/coronavirus-case-rates-and-death-rates-for-

16. NCHS - 404 Error - Resource Not Available.
http://www.cdc.gov. Published June 1, 2019. Accessed May 1, 2022. https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/.Accessed
17. Lincoln KD, Abdou CM, Lloyd D. Race and Socioeconomic Differences in Obesity and Depression among Black and Non-Hispanic White Americans. Journal of Health Care for the Poor and Underserved. 2014;25(1):257-275. doi:10.1353/hpu.2014.0038
18. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Baciu A, Negussie Y, Geller A, et al., eds. Communities in Action: Pathways to Health Equity. Washington (DC): National Academies Press (US); January 11, 2017.
19. Singh GK, Daus GP, Allender M, et al. Social Determinants of Health in the United States: Addressing Major Health Inequality Trends for the Nation, 1935-2016. Int J MCH AIDS. 2017;6(2):139-164. doi:10.21106/ijma.236
20. Walker RJ, Strom Williams J, Egede LE. Influence of Race, Ethnicity and Social Determinants of Health on Diabetes Outcomes. Am J Med Sci. 2016;351(4):366-373. doi:10.1016/j.amjms.2016.01.008
21. Noonan AS, Velasco-Mondragon HE, Wagner FA. Improving the health of African Americans in the USA: an overdue opportunity for social justice. Public Health Rev. 2016;37:12. Published 2016 Oct 3. doi:10.1186/s40985-016-0025-4
22. Holmes L Jr, Shutman E, Chinaka C, Deepika K, Pelaez L, Dabney KW. Aberrant Epigenomic Modulation of Glucocorticoid Receptor Gene (NR3C1) in Early Life Stress and Major Depressive Disorder Correlation: Systematic Review and Quantitative Evidence Synthesis. Int J Environ Res Public Health. 2019;16(21):4280. Published 2019 Nov 4. doi:10.3390/ijerph16214280
23. Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB. Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 2020;323(18):1824-1836. doi:10.1001/jama.2020.6019
24. Holmes L Jr, Chan W, Jiang Z, Du XL. Effectiveness of androgen deprivation therapy in prolonging survival of older men treated for locoregional prostate cancer. Prostate Cancer Prostatic Dis. 2007;10(4):388-395. doi:10.1038/sj.pcan.4500973