Health Outcomes of American Indians and Non-American Indians Hospitalized with COVID-19 in Western South Dakota.

Introduction: The purpose of this project was to determine the presence of disproportionate health outcomes during COVID-19 hospitalizations between American Indian and non-American Indian populations in western South Dakota.

Methods: A retrospective chart review study was conducted from March 29, 2020-November 30, 2021 at a 400 bed community hospital in western South Dakota. Groups were categorized by American Indian status (AI) and Non-American Indian status (NAI) based on admission paperwork. Numerical data points collected include: age of admits, length of stay, and number of comorbidities (including CHF, CHD, CAD, ESRD, ESLD, HTN, diabetes, obesity, immunocompromised status). Numerical data points were evaluated using a two sample t-test. Categorical data points included: ICU admission, ventilator use, and mortality. Categorical data points were evaluated using Chi-squared analysis with a two-tailed p-value of less than 0.05 for statistical significance and a degrees of freedom of 1.

Results: The average age of admission for AI was 52.4, and NAI was 64.5. The average number of comorbidities for AI was 2.16, and NAI was 1.96 (p = 0.003). The average length of stay for AI admits was 9.14, and 8.54 for NAI admits (p = 0.158). There was no relationship between AI status and ICU admission, X2. A significant relationship was present between AI status and ventilator use, X2.There was no relationship between AI status and mortality from COVID-19 illness, X2.

Conclusions: American Indians were hospitalized at younger ages and required greater use of ventilator assisted oxygenation therapy. Though mortality was similar between the groups, risk for long term morbidity, including post-acute coronavirus syndrome and ventilator-associated complications, may be greater among American Indians.