Background: The COVID-19 pandemic was first reported on March 7, 2020, in the District of Columbia (DC). Several baseline risk factors for mortality were identified among persons with COVID-19. However, the association between COVID-19 outcomes and existing disparities was unclear.

Objectives: To investigate the association between sociodemographic/clinical factors and COVID-19 mortality in Washington D.C.

Methods: Data from DC Health from March 2020 – January 2022 were collected for 130,949 COVID-19 cases including 1,289 deaths. We examined sociodemographic, clinical characteristics, and COVID-19 outcomes using descriptive analysis and logistic regression.

Results: Average age in years for cases was 34.2 (SD 19.29) and 71.5 (SD 14.68) for deaths. COVID-19 deaths were associated with age 75 and older (OR = 41.66, p <.0001); male (OR = 1.57, p <.0001); Black (OR = 3.47, p <.0001); non-Hispanic Black (OR = 1.86, p <.0001); and Ward 5 (OR =1.53, p =.008), Ward 6 (OR = 1.67, p = 0.03), and Ward 8 (OR =1.64, p = 0.002) residence; and having an underlying medical condition (OR = 37.26, p <.0001). Leading underlying conditions associated with COVID-19 deaths were heart disease (OR = 15.67, p <.0001), chronic kidney disease (OR = 15.23, p <.0001), transplanted organ (OR = 15.13, p <.0001); and shortness of breath (OR = 1.26, p = 0.001).

Conclusions: Persons of older age, male gender, Black populations, Wards residencies with majority populations of color, and having underlying health conditions had increased risk of COVID-19 mortality to varying degrees. Results highlight the importance of addressing inequities.