LAUSR

Key Points Question Are the higher in-hospital mortality rates for COVID-19 among American Indian and Alaska Native patients compared with other racial groups associated with differences in comorbidity burden? Findings In this cross-sectional study of 18 731 US adults hospitalized with COVID-19 in 2020, American Indian and Alaska Native patients had a lower mean comorbidity risk score compared with the overall patient population, yet they were significantly more likely than patients of all other races to die in the hospital. Increased COVID-19 in-hospital deaths among American Indian and Alaska Native adults were not associated with increased comorbidity experiences in all populations. Meaning These findings suggest that alternative factors contributing to disparate in-hospital mortality rates among Indigenous communities must be investigated further.