445. Correlative Factors for State to State Differences in the Prevalence and Case Fatality Rates of SARS-CoV-2, COVID-19 Infections in the United States of America

Abstract

Background: Individual States of the USA have ethnic, economic, community health and education differences that influence the prevalence and outcomes of COVID-19 infection. We hypothesized that Statewide differences in the prevalence and fatality rates of COVID-19 infections are dependent on factors that may be determined by mathematical modeling. Method(s): Two separate statistical regression models were developed using COVID-19 case prevalence and case fatality rates functioning as dependent variables. We obtained data from the prevalence and deaths from COVID-19 cases for each state in the USA that was posted at 4 PM Central Standard Time on April 29, 2020 from the Worldometer website. Publicly available databases were utilized to obtain data for the independent variables in the model. Result(s): Models are represented as follows: Statewide COVID-19 Prevalence Model Log (Statewide COVID-19 case prevalence) = 1.847* (100-250 individuals/mile2) +3.0025*(250+ individuals/mile2) + 1.021* (% African American population) +1.029* (% Hispanic American population +2.164 *(% adults aged 85+) Model results are shown in Table 1. Statewide COVID-19 Case Fatality Rate Model Log (Statewide COVID-19 case fatality rate) =2.194* (100-250 individuals/mile2) +2.758* (250+ individuals/mile2) +1.031* (% African American population) + 1.032* (% Hispanic American population) + 0.942 (% Native American population)+ 1.108 (% Asian American population) + 2.275 (% adults aged 85+) Model results are shown in Table 2. Conclusion(s): Higher State population density (See Figure 1 and Figure 2) and higher State populations of elderly persons correspond to increased prevalence and case-fatality rates of COVID-19 infections. Statewide data also shows health disparities for COVID-19 infections in Hispanic Americans, African Americans, and Asian Americans. Paradoxically, States with larger populations of Native Americans who have known poor outcomes from COVID-19 infection demonstrate a decrease in case-fatality rates, suggesting a large effect of healthcare inequality in this population. (Table Presented).