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Emerg Infect Dis . Differences in COVID-19 Fatality Rates among Ethnic Groups, Hawaii, USA, 2020-2022

tetano

Editor, Senior Moderator
Emerg Infect Dis


. 2025 Oct;31(10):1942-1949.
doi: 10.3201/eid3110.241070.
Differences in COVID-19 Fatality Rates among Ethnic Groups, Hawaii, USA, 2020-2022

Gehan Devendra, Madeleine Chai, Eyrica Sumida, Richard Chen, Maan Gozun, Dominic Chow, F DeWolfe Miller
Abstract

Asian American, Native Hawaiian, and Pacific Islander populations have been underrepresented in research on COVID-19 outcomes. We conducted a cross-sectional study of 5,494 electronic medical records of patients in a large tertiary care health system in the ethnically diverse state of Hawaii, USA. We compared fatality rates for hospitalized patients on the basis of race or ethnicity, age, vaccination status, and sequential organ failure assessment (SOFA) score at admission. Fatality rates varied between racial and ethnic groups but were associated with increasing age across all groups. Fatality rates were closely associated with increasing SOFA score and were inversely associated with the number of COVID-19 vaccinations received. We found that Asian and Pacific Islander groups experienced higher rates of in-hospital death and that death was strongly associated with increased age and SOFA score and with <1 COVID-19 vaccination. Clinicians should be aware of these outcomes when treating COVID-19 patients from these ethnic groups.

Keywords: Asian American Pacific Islanders; COVID-19; Hawaii; SARS; SARS-CoV-2; SOFA score; United States; coronavirus; coronavirus disease; fatality rate; hospital; respiratory infections; sequential organ failure assessment score; severe acute respiratory syndrome coronavirus 2; vaccination; viruses; zoonoses.

 
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