COVID-19 and exacerbation of screening mammography inequities.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6543-6543
Author(s):  
Gary X. Wang ◽  
Jarvis Chen ◽  
Leslie Lamb ◽  
Christian Testa ◽  
Pamela Waterman ◽  
...  
Keyword(s):  
Low Income ◽  
Screening Program ◽  
Tertiary Care ◽  
Screening Mammography ◽  
Population Composition ◽  
Chi Square ◽  
P Values ◽  
Increased Risk ◽  
Race Ethnicity ◽  
Zip Code

6543 Background: After state-mandated cessation of screening mammography (SM) in Spring 2020 due to COVID-19, centers were urged to resume screening, particularly of patients at increased risk. As our tertiary-care medical center’s screening program provides SM at four sites across our metropolitan area, we examined whether sites that historically served more patients from more disadvantaged areas returned slower to pre-COVID volumes. Methods: Patient records were linked by ZIP code of residence to ZIP Code Tabulation Area (ZCTA)-level area-based social metrics (ABSMs) from the 2014-2018 American Community Survey. We compared baseline pre-COVID (May-October, 2015-2019) SM population ABSMs between our four imaging sites for: % persons below poverty (≥ vs < 10%), % persons of color (POC) (quintiles: top 2 vs bottom 3), index of racialized economic segregation (quintiles: bottom 2 [more POC low-income households] vs top 3 [more white non-Hispanic (WNH) high-income households]); and race/ethnicity (% WNH vs POC). We modeled weekly SM volumes per screening day by site using Poisson regression and tested for weekly differences at each site, COVID-era (May-October 2020) vs pre-COVID; and tested for monthly differences in SM population composition by logistic regression modeling. Results: There were 89,082 pre-COVID and 16,220 COVID-era SM exams. At pre-COVID baselines the four sites differed in population composition by ABSMs and race/ethnicity (all chi-square P values <.001) (Table). The two sites that served more disadvantaged populations (A, B) returned slower to pre-COVID volumes (site-specific weekly screening volume no longer different [ P >.05] vs pre-COVID) (Table). As a result, compositions of the aggregate SM population across all sites showed a smaller proportion of patients from the most disadvantaged ZCTAs by ABSMs (all P values <.001) before returning to pre-COVID compositions three months after SM resumption. Conclusions: SM was slower to return to pre-COVID volumes at imaging sites that historically served lower-income communities of color. As a result, our COVID-era SM population skewed away from patients in disadvantaged ZCTAs. Our findings highlight the need to monitor for emergent disparities in the pandemic era. Future work will focus on understanding causes of inequitable SM engagement across our imaging sites to mitigate care disparities for our most vulnerable patients.[Table: see text]

Comparing shopper characteristics by online grocery ordering use among households in low-income communities in Maine

2021 ◽  
pp. 1-16
Author(s):  
Laura Y. Zatz ◽  
Alyssa J. Moran ◽  
Rebecca L. Franckle ◽  
Jason P. Block ◽  
Tao Hou ◽  
...  
Keyword(s):  
Low Income ◽  
Grocery Shopping ◽  
Sociodemographic Characteristics ◽  
Chi Square ◽  
Transaction Data ◽  
Future Studies ◽  
Number Of Children ◽  
Online Shoppers ◽  
Race Ethnicity ◽  
Improve Access

Abstract Objective: Online grocery shopping could improve access to healthy food, but it may not be equally accessible to all populations—especially those at higher risk for food insecurity. This study aimed to compare the sociodemographic characteristics of families who ordered groceries online versus those who only shopped in-store. Design: We analyzed enrollment survey and 44 weeks of individually-linked grocery transaction data. We used univariate chi-square and t-tests and logistic regression to assess differences in sociodemographic characteristics between households that only shopped in-store and those that shopped online with curbside pick-up (online only or online and in-store). Setting: Two Maine supermarkets. Participants: 863 parents or caregivers of children under 18 years old enrolled in two fruit and vegetable incentive trials Results: Participants had a total of 32 757 transactions. In univariate assessments, online shoppers had higher incomes (P<0.0001), were less likely to participate in WIC or SNAP (P<0.0001), and were more likely to be female (P=0.04). Most online shoppers were 30–39 years old, and few were 50 years or older (P=0.003). After controlling for age, gender, race/ethnicity, number of children, number of adults, income, and SNAP participation, female primary shoppers (OR=2.75, P=0.003), number of children (OR=1.27, P=0.04), and income (OR=3.91 for 186–300% FPL and OR=6.92 for >300% FPL, P<0.0001) were significantly associated with likelihood of shopping online. Conclusions: In this study of Maine families, low-income shoppers were significantly less likely to utilize online grocery ordering with curbside pick-up. Future studies could focus on elucidating barriers and developing strategies to improve access.

scholarly journals Multidimensional dynamic healthcare personnel (HCP)-centric model from a low-income and middle-income country to support and protect COVID-19 warriors: a large prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043837
Author(s):  
Usha Dutta ◽  
Anurag Sachan ◽  
Madhumita Premkumar ◽  
Tulika Gupta ◽  
Swapnajeet Sahoo ◽  
...  
Keyword(s):  
High Risk ◽  
Low Income ◽  
Tertiary Care ◽  
Low Risk ◽  
Transmission Risk ◽  
Healthcare Personnel ◽  
Risk Zone ◽  
Increased Risk ◽  
Medium Risk ◽  
Risk Zones

ObjectivesHealthcare personnel (HCP) are at an increased risk of acquiring COVID-19 infection especially in resource-restricted healthcare settings, and return to homes unfit for self-isolation, making them apprehensive about COVID-19 duty and transmission risk to their families. We aimed at implementing a novel multidimensional HCP-centric evidence-based, dynamic policy with the objectives to reduce risk of HCP infection, ensure welfare and safety of the HCP and to improve willingness to accept and return to duty.SettingOur tertiary care university hospital, with 12 600 HCP, was divided into high-risk, medium-risk and low-risk zones. In the high-risk and medium-risk zones, we organised training, logistic support, postduty HCP welfare and collected feedback, and sent them home after they tested negative for COVID-19. We supervised use of appropriate personal protective equipment (PPE) and kept communication paperless.ParticipantsWe recruited willing low-risk HCP, aged <50 years, with no comorbidities to work in COVID-19 zones. Social distancing, hand hygiene and universal masking were advocated in the low-risk zone.ResultsBetween 31 March and 20 July 2020, we clinically screened 5553 outpatients, of whom 3012 (54.2%) were COVID-19 suspects managed in the medium-risk zone. Among them, 346 (11.4%) tested COVID-19 positive (57.2% male) and were managed in the high-risk zone with 19 (5.4%) deaths. One (0.08%) of the 1224 HCP in high-risk zone, 6 (0.62%) of 960 HCP in medium-risk zone and 23 (0.18%) of the 12 600 HCP in the low-risk zone tested positive at the end of shift. All the 30 COVID-19-positive HCP have since recovered. This HCP-centric policy resulted in low transmission rates (<1%), ensured satisfaction with training (92%), PPE (90.8%), medical and psychosocial support (79%) and improved acceptance of COVID-19 duty with 54.7% volunteering for re-deployment.ConclusionA multidimensional HCP-centric policy was effective in ensuring safety, satisfaction and welfare of HCP in a resource-poor setting and resulted in a willing workforce to fight the pandemic.

Abstract 16584: Association of Lower Height and Higher LDL-c in a Statewide Schoolchild Cholesterol Screening Program

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Lee A Pyles ◽  
Christa Lilly ◽  
Eloise Elliott ◽  
William A Neal
Keyword(s):  
Short Stature ◽  
Odds Ratio ◽  
Screening Program ◽  
Nucleotide Polymorphisms ◽  
Chi Square ◽  
Primordial Prevention ◽  
Lipid Panel ◽  
Increased Risk ◽  
Lower Height ◽  
Chi Square Analysis

Introduction: The Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) Project has screened West Virginia 5th graders since 1998 to facilitate primordial prevention of coronary heart disease (CHD) in WV. LDL-c levels above 175 mg/dl in children suggest Familial Hyperlipidemia (FH) in the child’s family and a level above 160 mg/dl with history of CHD in relatives can also establish a diagnosis. Hypothesis: Based on previous adult literature, the association of lower height with higher LDL level observed in adults begins in childhood and is prominent in children with LDL in FH range. Methods: Fifth graders are screened yearly in WV schools with parental consent for Body Mass Index and lipid panel. Lipids were analyzed with respect to either short stature < 2 SD for height or comparing 1st (shortest) and 4th quartiles of the population. Statistical analysis for age- and gender-adjusted height percentiles was performed in SAS. Results: 59,386 children had lipid and height data. Mean LDL-c for 1st vs. 4th quartile of height was 94.08 mg/dl (95% Confidence Interval-CI 93.66-94.51) vs. 90.03 mg/dl (CI 89.65-90.42). First quartile of height students had average 4.05 mg/dl higher LDL-c (95% CI 3.48 -4.62 mg/dl). 4398 children had an LDL level above 130 g/dl, 632 above 160 mg/dl and 247 above 175 mg/dl. The Chi square analysis of short stature (height 130 g/dl was also significant (p=0.013) with increased odds of LDL-c above 130 g/dl compared to non-short stature (OR= 1.37, CL 1.07-1.75). Table 1 shows odds ratio for varying levels of elevated LDL-c for the first (shortest) vs. 4th (tallest) quartile of students. Conclusions: Shorter stature is associated with higher LDL-c level in WV 5th graders generally and in those children with increased risk for genetic dyslipidemia. The trend to increasing odds ratio in strata of higher LDL-c supports a recent report of association of single nucleotide polymorphisms selecting for lower genetic height and higher LDL-c.

scholarly journals Analysis of COVID-19 Case Demographics in Gary, Indiana

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Yazan Al-Tarshan ◽  
Maryam Sabir ◽  
Cameron Snapp ◽  
Martin Brown ◽  
Roland Walker ◽  
...  
Keyword(s):  
Low Income ◽  
Household Income ◽  
Black Population ◽  
Health Department ◽  
Poverty Line ◽  
Median Household Income ◽  
Predominantly Black ◽  
Chi Square ◽  
Gary Indiana ◽  
Zip Code

Background and Hypothesis  It has been reported in several recent studies that health disparities associated with COVID-19 infection r are prevalent in Black and impoverished populations. The contribution of multiple causes to these disparities is still not completely elucidated. Gary, Indiana has a large Black population (80%), high number of residents living below the poverty line (34%), and high unemployment rate (20%). We hypothesized that Black individuals in Gary have a higher rate of positive cases, hospitalizations, and deaths than non-Black individuals. Also, we hypothesized that (median household income measured by the zip code) is negatively correlated with COVID-19 positive cases, hospitalizations, and deaths.     Methods  In collaboration with the Gary Health Department, we analyzed data on all positive cases in the city from 06/16/2020 through 06/07/2021(totally 5149 cases). We compared this data to the data from 03/16/2020 through 06/16/2020 (totally 724 cases) that we analyzed previously. Data was de-identified and included age, race, ethnicity, and zip code.  The data was analyzed using Pearson's chi-square test and regression analysis.    Results   When compared to the non-Black population in Gary age and population-adjusted rates of hospitalizations and deaths in the Black population are 3-fold (p<9.385E-11) and 2-fold (p<0.0171) higher, respectively. Surprisingly, the non-Black population had a higher infection rate than the Black population (p<2.69E-09). Median household income of a zip code is negatively correlated with COVID-19 hospitalizations in that zip code (R2=0.6345, p=0.03), but is does not affect the .rates of infections and deaths.     Conclusion   Our data show that in Gary, there is a clear health disparity of both income and race, specifically in the context of COVID-19. IUSMNW and Gary health officials can collaborate and utilize this data to reallocate resources to the highly populated, low income, and predominantly Black neighborhoods.  

scholarly journals Seroprevalence and Risk Factors of SARS CoV-2 in Health Care Workers of Tertiary-Care Hospitals in the Province of Khyber Pakhtunkhwa, Pakistan

2020 ◽  
Author(s):  
Mohsina Haq ◽  
Asif Rehman ◽  
Muhammad Noor ◽  
Jawad Ahmed ◽  
Junaid Ahmad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Low Income ◽  
Tertiary Care ◽  
Healthcare Delivery ◽  
Developed Countries ◽  
Protective Measure ◽  
Special Importance ◽  
Khyber Pakhtunkhwa ◽  
Increased Risk ◽  
Tertiary Care Hospitals

Background: High number of SARS CoV2 infected patients has overburdened healthcare delivery system, particularly in low-income countries. In the recent past many studies from the developed countries have been published on the prevalence of SARS CoV2 antibodies and the risk factors of COVID 19 in healthcare-workers but little is known from developing countries. Methods: This cross-sectional study was conducted on prevalence of SARS CoV2 antibody and risk factors for seropositivity in HCWs in tertiary care hospitals of Peshawar city, Khyber Pakhtunkhwa province Pakistan. Findings: The overall seroprevalence of SARS CoV2 antibodies was 30.7% (CI, 27.8 to 33.6) in 1011 HCWs. Laboratory technicians had the highest seropositivity (50.0%, CI, 31.8 to 68.1). Risk analysis revealed that wearing face-mask and observing social-distancing within a family could reduce the risk (OR:0.67. p<0.05) and (OR:0.73. p<0.05) while the odds of seropositivity were higher among those attending funeral and visiting local-markets (OR:1.83. p<0.05) and (OR:1.66. p<0.01). In Univariable analysis, being a nursing staff and a paramedical staff led to higher risk of seropositivity (OR:1.58. p< 0.05), (OR:1.79. p< 0.05). Fever (OR:2.36, CI, 1.52 to 3.68) and loss of smell (OR:2.95, CI: 1.46 to 5.98) were significantly associated with increased risk of seropositivity (p<0.01). Among the seropositive HCWs, 165 (53.2%) had no symptoms at all while 145 (46.8%) had one or more symptoms. Interpretation: The high prevalence of SARS CoV2 antibodies in HCWs warrants for better training and use of protective measure to reduce their risk. Early detection of asymptomatic HCWs may be of special importance because they are likely to be potential threat to others during the active phase of viremia. Funding: Prime Foundation Pakistan.

Findings from the screening echocardiograms performed on survivors of childhood cancer treated with anthracyclines and/or chest radiation

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 20001-20001
Author(s):  
J. Andolina ◽  
K. J. Dilley
Keyword(s):  
Radiation Exposure ◽  
Cumulative Dose ◽  
Screening Program ◽  
Cell Transplant ◽  
Age Group ◽  
Chi Square ◽  
Screening Guidelines ◽  
Increased Risk ◽  
Screening Study

20001 Background: Treatment with anthracyclines or chest radiation confers an increased risk of cardiomyopathy persisting for years after treatment ends. The Children’s Oncology Group (COG) has created guidelines for how often to screen cardiac function in long-term survivors of pediatric cancers based on age at treatment and total cumulative dose of anthracyclines. The objective was to examine the findings from a screening program using these guidelines. Methods: Medical record reviews were performed for all patients ever seen in the past 10 years in the long-term follow-up (LTFU) program at a single institution. Reviews examined treatment variables such as diagnosis, age at diagnosis and anthracycline cumulative dose as well as the shortening fraction (SF) from any echocardiogram (echo) performed as a screening study at =4 years from diagnosis (LTFU screening echo). Analyses include Chi-square and logistic regression. Results: 365 patients seen in the LTFU program at =5 years from diagnosis were considered at risk for cardiomyopathy due to anthracycline therapy or radiation exposure to the chest (including total body irradiation). Patients were 56.4% male and 65.5% white. Acute leukemia, neuroblastoma, Wilm’s tumor and lymphoma made up 82.2% of the diagnoses. 312/365 (85.5%) had ever had an LTFU screening echo. Younger age group at treatment as divided in the COG guidelines (<1y, 1–4y, =5y) was associated with likelihood of ever having an LTFU screening echo (p=0.018). 25/312 (8.0%) ever had a SF <28% in one of those LTFU studies. Only 5 of those 25 had an abnormal echo prior to presenting to LTFU. Age group at treatment was not significantly associated with likelihood of a SF <28% (p=0.939), but anthracycline dose of =250 mg/m2 was associated (OR 5.9, 95% CI 2.3–15.3). Radiation exposure, stem cell transplant and history of relapse were not associated with SF <28%, but prior abnormal echo was associated (p=0.032 exact). Cardiology referral was more likely in patients who ever had a SF <28% (p<0.001). Conclusions: Only 8% of patients being screened in a LTFU program for anthracycline-induced cardiomyopathy ever had a SF <28%. Further exploration of whether the age- and dose- stratified screening guidelines can be simplified is warranted. No significant financial relationships to disclose.

scholarly journals A retrospective study of serious adverse drug reactions and associated risk factors in a tertiary care hospital

2019 ◽  
Vol 9 (1) ◽  
pp. 101
Author(s):  
Smita Shenoy ◽  
Mohit Gupta ◽  
Sadhana Holla ◽  
Madhurima Home ◽  
Harish Thanusubramanian
Keyword(s):  
Risk Factors ◽  
Adverse Drug Reactions ◽  
Anticancer Agents ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Concomitant Disease ◽  
Care Hospital ◽  
Drug Reactions ◽  
Chi Square ◽  
Increased Risk

Background: Serious adverse drug reactions (ADRs) cause physical, psychological and economic harm to patients and society. This study was undertaken to understand serious ADRs in a tertiary care hospital and risk factors associated with it.Methods: The serious adverse reactions that occurred over a one-year period were assessed. The serious adverse drug reactions, action taken, outcome, predictability, suspect drug, causality, patient demographics and risk factors for the reaction was collected. Chi-square test was applied for observing relationships of predisposing factors for serious ADRs.Results: Out of a total of 984 reported adverse drug reactions, 94 (9.55%) were serious. Hematological disorders (41.05%) were the common serious ADRs followed by electrolyte disturbances (18.94%). Anticancer agents were the suspect drugs for majority of serious ADRs. Serious ADRs contributed to 39 (0.05%) admissions in the hospital. Recovery occurred in 97.87% of the patients. The causality was possible in 91.48% (n=86) and probable in 8.51% (n=8) of the serious adverse drug reactions. Males, patients even with a single concomitant disease and those with more than 2 concomitant medications were at increased risk (p<0.05) for developing serious ADRs.Conclusions: Serious ADRs are a significant problem in health care. Measures should be taken to detect and treat them at the earliest to reduce suffering of the patient.

The impact of obesity on treatment and outcomes in ovarian cancer by race/ethnicity.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18067-e18067
Author(s):  
Alexandra Martin ◽  
Adrianne Rose Mallen ◽  
Sweta Sinha ◽  
Ali Wells ◽  
Kathryn Cline ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Dose Reduction ◽  
Cancer Patients ◽  
Tertiary Care ◽  
Dose Intensity ◽  
Comprehensive Cancer Center ◽  
Increased Risk ◽  
Race Ethnicity ◽  
Similar Survival ◽  
The Impact

e18067 Background: Concern for toxicities in obese ovarian cancer patients may limit weight-based chemotherapy dosing, which has been associated with poor survival. We sought to evaluate the impact of obesity on treatment and outcomes by race/ethnicity at a National Cancer Institute (NCI)-designated Comprehensive Cancer Center (CCC). Methods: 66 minority (non-Hispanic black, Hispanic) epithelial ovarian cancer patients diagnosed 2006 and treated with frontline chemotherapy were frequency matched to two non-Hispanic white (NHW) patients by 5-year age group and stage (n = 198). For frontline carboplatin, relative dose intensity (RDI) was calculated by dividing the dose received by the expected dose, with an RDI < 0.85 indicating carboplatin dose reduction. Patient characteristics and RDI were compared by obesity and race/ethnicity. Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between obesity, race/ethnicity and RDI with mortality, adjusting for confounders. Results: Minorities were more likely to be obese, underinsured, and to experience delays in chemotherapy compared to NHW. Compared to normal/overweight patients, obese patients were more likely to experience carboplatin under dosing in the neoadjuvant (p = 0.004) and adjuvant (p < 0.0001) setting, but there were no differences in RDI by race/ethnicity or toxicities. No association with survival was observed for dose reduction and BMI. Compared to NHW, minorities had similar survival in the first 4 years after diagnosis (HR = 0.99, 95% CI = 0.60-1.63), but an increased risk of mortality > 4 years after diagnosis (HR = 4.07, 95% CI = 1.92, 8.60). Conclusions: Even though minorities were more likely to be obese, there were no differences in dosing by race/ethnicity at an NCI CCC. Minorities had similar survival to NHW in the first 4 years after diagnosis, likely due to similar access to quality care at an NCI CCC. However, > 4 years after diagnosis, the racial/ethnic survival disparity persisted after adjustment for clinical and pathologic characteristics. Expansion of this work to other patient populations may help determine if findings are similar outside of a tertiary care center.

Prevalence and socioeconomic factors in the prescription of concurrent amphetamine and alprazolam

2020 ◽  
pp. 009121742096061
Author(s):  
Paul A Zarkowski ◽  
Alex R Van-Den-Ende ◽  
Jacob A Groen
Keyword(s):  
Socioeconomic Factors ◽  
Low Income ◽  
Household Income ◽  
Monitoring Program ◽  
High Income ◽  
Urban Setting ◽  
Increased Risk ◽  
Prescription Rates ◽  
Zip Code ◽  
Low Income Households

Objective Goals were to determine the prevalence of concurrent prescription of amphetamine and alprazolam, and examine variation by socioeconomic factors. Methods Washington State’s Prescription Monitoring Program was reviewed for calendar years 2013 through 2017. Individuals receiving more than 180 days of amphetamine, alprazolam or both were tabulated for each zip code. Prescription rates were compared between zip codes with variation in rural/urban setting and fraction of low and high income households using a multiple regression. Results One in 3920 individuals in the general population of Washington State were taking a combination of alprazolam and amphetamine. The statewide prevalence of this combination increased 40.2% between 2013 and 2017. The prevalence of the combination in each zip code is significantly positively correlated with the fraction of high income households, p < 0.001, and urban area, p < 0.05. In contrast, the prevalence of amphetamine increased with both the fraction of high income, p < 0.001, and low income households, p < 0.01, with an incremental increase over twice as large with fraction of high income (b = 232 (25)) than low income households (b = 102 (38)). In contrast, alprazolam decreased in prevalence with the fraction of high income households, p < 0.05. Conclusions The prevalence of concurrent prescription of alprazolam and amphetamine correlates with local socioeconomic factors, including greater household income, instead of the prevalence of FDA indications, including anxiety disorders or ADHD. More clinical studies are required to establish efficacy and guidelines for safe use to mitigate the increased risk of accidents in patients taking concurrent amphetamine and alprazolam.

scholarly journals Mechanisms of socioeconomic differences in COVID-19 screening and hospitalizations

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255343
Author(s):  
Jarrod E. Dalton ◽  
Douglas D. Gunzler ◽  
Vardhmaan Jain ◽  
Adam T. Perzynski ◽  
Neal V. Dawson ◽  
...  
Keyword(s):  
Emergency Department ◽  
Low Income ◽  
Cleveland Clinic ◽  
Symptom Profiles ◽  
Black Patients ◽  
Increased Risk ◽  
Comorbidity Burden ◽  
Observational Cohort ◽  
Race Ethnicity ◽  
Hispanic White

Background Social and ecological differences in early SARS-CoV-2 pandemic screening and outcomes have been documented, but the means by which these differences have arisen are not well understood. Objective To characterize socioeconomic and chronic disease-related mechanisms underlying these differences. Design Observational cohort study. Setting Outpatient and emergency care. Patients 12900 Cleveland Clinic Health System patients referred for SARS-CoV-2 testing between March 17 and April 15, 2020. Interventions Nasopharyngeal PCR test for SARS-CoV-2 infection. Measurements Test location (emergency department, ED, vs. outpatient care), COVID-19 symptoms, test positivity and hospitalization among positive cases. Results We identified six classes of symptoms, ranging in test positivity from 3.4% to 23%. Non-Hispanic Black race/ethnicity was disproportionately represented in the group with highest positivity rates. Non-Hispanic Black patients ranged from 1.81 [95% confidence interval: 0.91–3.59] times (at age 20) to 2.37 [1.54–3.65] times (at age 80) more likely to test positive for the SARS-CoV-2 virus than non-Hispanic White patients, while test positivity was not significantly different across the neighborhood income spectrum. Testing in the emergency department (OR: 5.4 [3.9, 7.5]) and cardiovascular disease (OR: 2.5 [1.7, 3.8]) were related to increased risk of hospitalization among the 1247 patients who tested positive. Limitations Constraints on availability of test kits forced providers to selectively test for SARS-Cov-2. Conclusion Non-Hispanic Black patients and patients from low-income neighborhoods tended toward more severe and prolonged symptom profiles and increased comorbidity burden. These factors were associated with higher rates of testing in the ED. Non-Hispanic Black patients also had higher test positivity rates.

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