Racial Disparities in COVID-19-associated Ischemic Stroke Outcomes

As the USA confronts both COVID-19 and issues regarding race, I think it is important to highlight one big way that these issues intersect: disparities in health outcomes during this pandemic. There are many social barriers, as well as lack of scientific knowledge, that have led to African Americans having generally worse health outcomes (Mays, Cochran, Barnes, 2007). This week’s article reveals that, unfortunately, a similar trend is observed during the COVID-19 crisis.

Writing in the Journal of Neurology, Neurosurgery, and Psychiatry, Dmytriw et al. report on 69 cases of ischemic stroke associated with COVID-19, which has been reported as a complication of COVID-19 in other studies, and even occurs in some younger patients (see blog post 6/23/20). 27 of these patients were of African American background and their health outcomes were compared to patients from all other racial backgrounds (Dmytriw et al., 2020). The largest differences observed were that African Americans suffered from higher rates of symptomatic intracranial hemorrhage (11.1% vs 3%, p<0.001) and mortality (55.6% vs 28.6%, p=0.05). While differences in infection rates and outcomes among racial groups have been noted during this pandemic, the cause is so far unknown. The authors speculate that one reason for the high mortality rate among African Americans could be due to disparities in access to healthcare and the resulting subclinical or undiagnosed comorbidities.

Whatever the cause may be, it is important to highlight these disparities in health outcomes so that we may identify the social, economic, and scientific barriers that lead to disproportionate suffering along racial lines.