Black and Hispanic coronavirus patients had lung damage 1.5 times worse than white Americans did

Black and Hispanic coronavirus patients had lung damage that was 1.5 times worse than the infection’s attacks on white Americans, X-rays reveal

  • Researchers looked at chest X-rays of 326 patients hospitalized with coronavirus between March 27 and April 10
  • Patients were given mRALE scores based on how severely the disease had impacted their lungs
  • White patients had a median score of 4.2 but minority patients had scores of 6.1 – about 1.5 times worse 
  • The team says this is likely due to limited English proficiency among particularly Hispanic patients and waiting to seek medical care  

Minority patients hospitalized with the novel coronavirus are more likely to have more serious cases of the illness, a new study suggests.

Researchers found that chest X-rays of blacks and Hispanics showed more severe disease progression than whites – about 1.5 times worse.

Scans of patients of color were more likely to be opaque, meaning there could be a buildup of fluid, a thickening of connective tissues or damage to the organs.  

The team, from Massachusetts General Hospital, says it believes this is due to language barriers among minorities who might not understand all the information being circulated about COVID-19 as well as minorities being more likely to work essential jobs that put them at higher risk of contracting the virus.  

In a new study from Massachusetts General Hospital, coronavirus patients were given mRALE scores based on how severely the disease had impacted their lungs (above)

White patients had a median score of 4.2 but minority patients had scores of 6.1 - about 1.5 times worse (above)

White patients had a median score of 4.2 but minority patients had scores of 6.1 – about 1.5 times worse (above)

For the study, published in the journal Radiology, the team looked at data from 326 patients hospitalized with COVID-19 between March 27 and April 10, 2020. 

The clinic is in Chelsea, a city four miles north of Boston that is predominantly home to a Spanish-speaking Hispanic community. 

Researchers looked at chest X-rays and assigned them modified Radiographic Assessment of Lung Edema (mRALE) scores.

mRALE measures the severity and density of opaqueness in the alveoli, the tiny air sacs of the lungs, that are either filled with fluid, inflamed or scarred.

Minority patients had much higher mRALE scores with a median of 6.1 whereas white patients had a median score of 4.2.

Additionally, no white patient had a score above 16, but non-white patients had scores as high as 21. 

Researchers say there are a number of factors that influenced why more serious lung disease showed up on chest X-rays of non-white patients.

This includes a higher prevalence of pre-existing conditions and limited understanding of the English language. 

‘Limited English proficiency is an additional socioeconomic factor that really influences many aspects of access to care,’ said co-author Dr Efren Flores, a radiologist at Massachusetts General Hospital.

‘When we were first learning how the disease spreads, there was all this rapidly evolving information coming out that was not available in languages other than English.

‘That lag in availability of actionable health information for non-English speaking individuals was really critical for many patients trying to navigate a complex medical system with a disease from a virus that is so aggressive.’ 

Flores also said that many non-white patients also waited to seek medical care due to working so-called essential jobs. 

‘Many of these patients delay their care because they’re considered essential workers and they don’t have a lot of sick leave, but also it’s difficult for them to leave because they are living on a weekly paycheck and have other dependents,’ he said.

It wasn’t uncommon for us to go into the medical record when we were interpreting their exams and see that many of them worked at grocery stores or warehouses.’  

The team says the findings could help radiologists develop algorithms identify the most vulnerable populations so that medical professionals can provide preventative care. 

‘We did this study not only to gain a better understanding of these emerging disparities, but also to discover how we can use this information to craft a better path towards equity together,’ Flores said.

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