More people who died with COVID-19 are older and have underlying health conditions, however younger nonwhite patients with COVID-19 died at a disproportionately higher rate than younger white patients, the federal Centers for Disease Control and Prevention (CDC) has found.
The CDC on July 10 released a Morbidity and Mortality Report on the characteristics of more than 10,000 people who died with COVID-19 in the U.S. from Feb. 12-May 18 using case-based surveillance and supplementary data from 16 jurisdictions, including Minnesota.
This information, and understanding the factors that contribute to the COVID-19 mortality differences among races and ethnicities, can be used to inform medical and public health officials to prevent COVID-19 deaths by encouraging the at-risk groups to better practice preventative measures, like wearing masks, and to seek medical care quickly if they get sick.
Here's what the CDC found:
COVID-19 patients by age and race
- 74.8 percent of people who died of COVID 19 were 65 years and older. This is consistent with what other reports characterizing COVID-19 deaths have found in the U.S. and China.
- The median age among Hispanic and nonwhite patients with COVID-19 who died is 71 and 72, respectively. That's 9-10 years younger than the median age of white patients with COVID-19 who died (81 years).
- 34.9 percent of Hispanic patients (908) with COVID-19 who died were younger than 65 and 29.5 percent of nonwhite patients with COVID-19 who died were younger than 65 years old. Meanwhile, 13.2 percent of white patients with COVID-19 who died were younger than 65.
- The percent of both Hispanic and nonwhite patients younger than 65 who died with COVID-19 exceeds the percentage of Hispanic and nonwhite people younger than 65 in the U.S. (20 percent and 23 percent, respectively).
The CDC says more study is needed to understand why there are these differences among racial groups, calling the "relatively high percentages" of Hispanic and nonwhite patients younger than 65 who died with COVID-19 "notable."
It could be that the pandemic disproportionately affected younger, nonwhite people during the study period or it could be that the transmission rate is higher among younger nonwhite people than it is among white people, the report said. A contributing factor to a higher transmission rate could be that higher percentages of Hispanic and nonwhite people work in jobs like don't always allow for physical distancing, such as the service industry.
Underlying medical conditions
- 76.4 percent of patients (8,134 people) who died with COVID-19 had one or more underlying medical conditions reported. This is consistent with what other reports characterizing COVID-19 deaths have found in the U.S. and China.
- Cardiovascular disease and diabetes were the most common listed underlying medical conditions of those reported – 60.9 percent of patients (6,481) who died with COVID-19 had cardiovascular disease, 39.5 percent of patients (4,210) who died with COVID-19 had diabetes.
- 83.1 percent (2,228 patients) who were younger than 65 and died with COVID-19 had at least one underlying health condition listed.
- Of those who died with COVID-19 and were younger than 65, 49.6 percent (1,330) had diabetes. That's "substantially higher" than an analysis of hospitalized COVID-19 patients 65 and younger (35 percent had diabetes) and the general population with diabetes (less than 20 percent).
The CDC says public health communication campaigns could encourage patients with COVID-19 who have underlying medical conditions to seek medical care earlier in their illness.
Meanwhile, the CDC says health care providers should consider the possibility of disease progression people with underlying health conditions and those under 65 who are Hispanic and nonwhite.
Where they died
- 62 percent of the patients (6,604 people) who died with COVID-19 died in the hospital; 5.2 percent (549 people) died in the emergency department; 5.3 percent (567 people) died in a long-term care facility; and fewer than 1 percent died either at home (79 people) or in hospice (28 people). Meanwhile, for 26.5 percent of cases (2,820 people), the location of death is listed as unknown.
- Of the patients younger than 65 who died with COVID-19, 7.8 percent died in an emergency room (6.8 percent/181 people) or at home (1 percent/27 people). The out-of-hospital deaths may reflect a lack of health care access, delays in seeking care or diagnostic delays, the CDC notes.
Using the data
The CDC says public health officials at the regional and state levels should examine the roles age, race, disease severity, underlying medical conditions, socioeconomic status, behavioral factors and out-of-hospital deaths play transmission of the virus and deaths associated with it. Doing so could lead to community-level prevention initiatives to prevent more COVID-19-related deaths.
Such initiatives could be campaigns directed toward informing Hispanic and nonwhite people younger than 65 about the importance of social distancing and the need to wear masks in public.