P1619 - Racial Disparities in the Incidence and Severity of Hospitalizations for Concomitant COVID-19 and Clostridioides difficile Infection

Megan B. Ghai, MD, MPH, MA¹, Pooja Rangan, MBBS, MPH¹, Wahid Wassef, MD, MPH, FACG^2
1University of Arizona College of Medicine, Phoenix, AZ; ²Banner University Medical Center, Phoenix, AZ

Introduction: There is a reported association of COVID-19 with Clostridioides difficile infection (CDI). However, it is unknown if there are racial groups that are disproportionately affected by COVID-19 and CDI. Presented is a population-based analysis characterizing the incidence and severity of hospitalizations for concomitant CDI and COVID-19 by race.

Methods: A retrospective analysis of U.S. inpatient discharges from 2020 using the Healthcare Cost and Utilization Project National Inpatient Sample was performed comparing those hospitalized for CDI with and without COVID-19. Included were adult CDI discharges, as defined by ICD-10-CM codes. Weights were used to generate nationally representative estimates. Descriptive statistics were produced using Pearson’s chi-squared tests. Severity was evaluated, as defined by mean length of stay (LOS) and mortality, using linear regression and Pearson’s chi-squared tests. Multivariate logistic regression was used to evaluate the independent association of COVID-19 by race in those with CDI.

Results: Included were 215,580 weighted inpatient discharges for CDI, 4.97% of which had a concomitant diagnosis of COVID-19 (table 1). White patients made up 73.9% of the CDI cohort without COVID-19 but only 59.5% of the CDI cohort with COVID-19. While Hispanic patients made up 7.9% of the CDI without COVID-19 but 13.5% of the CDI with COVID-19 [X²(5, N=210,685)= 223.5, p < 0.001]. The adjusted odds of concomitant CDI and COVID-19 diagnoses in the Hispanic population was nearly double, as compared to other races, after adjusting for age, race, sex, BMI, complications of CDI, and risk factors for developing worsening COVID-19 (OR=1.95, 95% CI [1.47, 2.58], p < 0.001). Mean LOS (+9.78 days, p =0.001) and mortality (5.85% vs 23.10%, p < 0.001) also increased most significantly in the Hispanic population in those with concomitant CDI and COVID-19 compared to those without COVID-19.

Discussion: In those hospitalized for CDI, the Hispanic population was disproportionately affected by COVID-19 even after adjusting for known comorbidities of COVID-19. Mean LOS and death rate among those with CDI and concomitant COVID-19 were also most severe in the Hispanic population. Based on these results, increased efforts at COVID-19 primary prevention should be directed toward the Hispanic population. Further, co-infection with concomitant CDI and COVID-19 should be aggressively treated among those of the Hispanic population.


Disclosures:


Megan B. Ghai, MD, MPH, MA¹, Pooja Rangan, MBBS, MPH¹, Wahid Wassef, MD, MPH, FACG². P1619 - Racial Disparities in the Incidence and Severity of Hospitalizations for Concomitant COVID-19 and Clostridioides difficile Infection, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.