Health Disparities and Risk Patterns of COVID-19 Case, Hospitalization, and Case Fatality in Texas Comparted to the United States of America

Purpose: Explore age, sex, race, and underlying condition distribution with COVID-19-related case, hospitalization, and mortality rates. Methods: Secondary retrospective cohort analysis used CDC's and TDSHS's COVID-19 Data Tracker to obtain hospitalization, intensive care, mortality, and demographic counts of confirmed COVID-19 cases from submitted state and territorial health departments and case reports in U.S.A. and Texas (2020). Statistical analysis was conducted using SPSS. Results: In U.S., there were 12,573,876 COVID-19 cases, 688,911 hospitalizations, 74,933 ICU admissions, and 222,575 deaths compared to 1,551,250 cases and 30,741 deaths in Texas. 48% U.S. cases were male compared to 63.3% in Texas. Females had 19% and 22.5% lower risk of hospitalization and mortality compared to males(P< 0.001). Whites (54.1%) and Hispanics (21.3%) consisted of most cases. Blacks had 2.47 [RR 2.47,95%CI(2.42-2.52)] times higher risk of ICU admission and 16% higher mortality risk. Hispanics had 20% higher ICU risk but 35% [RR 0.647,95%CI(0.638-0.656)] lower risk of death compared to Whites(P< 0.001). Pediatric cases had 80% lower mortality risk; older adults with 15.3% case fatality ratio had 87.31 [RR 87.31,95%CI(84.55-90.16)] times mortality risk compared to adults 20-39 years old. Underlying conditions had 17 times higher risk of mortality compared to no health conditions(P< 0.001). Conclusions: Increasing age, male sex, underlying conditions, and Black race are associated with poorer outcomes in COVID-19. Healthcare professionals should be aware of COVID-19 health disparities and risk factors for poor outcomes to better address public health gaps and promote targeted interventions.