Racial and ethnic disparity in clinical outcomes among patients with confirmed COVID-19 infection in a large US electronic health record database.
Racial and ethnic disparity in clinical outcomes among patients with confirmed COVID-19 infection in a large US electronic health record database.
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DOI：
10.1016/j.eclinm.2021.101075
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发表时间：
2021-09
影响因子：
15.1
通讯作者：
Currie UM
中科院分区：
文献类型：
--
作者：
Buikema AR;Buzinec P;Paudel ML;Andrade K;Johnson JC;Edmonds YM;Jhamb SK;Chastek B;Raja H;Cao F;Hulbert EM;Korrer S;Mazumder D;Seare J;Solow BK;Currie UM
种族和少数民族群体受到美国冠状病毒病2019年(新冠肺炎)大流行的不成比例的影响；然而，按种族/民族分层并根据临床特征进行调整的全国范围内关于新冠肺炎结果的数据很少。这项研究分析了种族/民族对美国新冠肺炎患者预后的影响。这是一项对2020年2月1日至2020年9月14日电子健康记录中确诊为新冠肺炎的患者进行的回顾性观察研究。根据种族/民族(西班牙裔、非西班牙裔黑人[黑人]、非西班牙裔白人[白人]、非西班牙裔亚裔[亚洲人]或其他/未知)评估指数遭遇地点、住院和死亡率。种族/民族类别与根据患者特征调整的研究结果之间的关联使用Logistic回归进行评估。在202,908名确诊的新冠肺炎患者中，种族/少数民族患者比白人患者更有可能在首次发病时住院(西班牙裔：调整后的优势比1·690，95%CI 1·620-1·763；黑人：1·810，1·743-1·880；亚裔：1·503，1·381-1·636)和在随访期间(西班牙裔：1·700，1·638-1·764；黑人：1·578，1·526-1·633；亚裔：1·391，1·288-1·501)。在住院患者中，黑人患者的调整死亡风险较低(0.881，0.809-0.959)，而亚洲患者的调整后死亡风险较高(1.205,1000-1.452)。与白人患者相比，患有新冠肺炎的种族/少数民族患者在最初表现时有更严重的疾病。黑人患者住院治疗降低了死亡风险，但亚裔患者没有，这表明不同人群的预后差异可能是由不同的因素调节的。除了制定政策促进公平获得新冠肺炎相关护理外，还需要对按人口分类的新冠肺炎数据进行进一步分析。没有。
Racial and ethnic minority groups have been disproportionately affected by the US coronavirus disease 2019 (COVID-19) pandemic; however, nationwide data on COVID-19 outcomes stratified by race/ethnicity and adjusted for clinical characteristics are sparse. This study analyzed the impacts of race/ethnicity on outcomes among US patients with COVID-19. This was a retrospective observational study of patients with a confirmed COVID-19 diagnosis in the electronic health record from 01 February 2020 through 14 September 2020. Index encounter site, hospitalization, and mortality were assessed by race/ethnicity (Hispanic, non-Hispanic Black [Black], non-Hispanic White [White], non-Hispanic Asian [Asian], or Other/unknown). Associations between racial/ethnic categories and study outcomes adjusted for patient characteristics were evaluated using logistic regression. Among 202,908 patients with confirmed COVID-19, patients from racial/ethnic minority groups were more likely than White patients to be hospitalized on initial presentation (Hispanic: adjusted odds ratio 1·690, 95% CI 1·620–1·763; Black: 1·810, 1·743–1·880; Asian: 1·503, 1·381–1·636) and during follow-up (Hispanic: 1·700, 1·638–1·764; Black: 1·578, 1·526–1·633; Asian: 1·391, 1·288–1·501). Among hospitalized patients, adjusted mortality risk was lower for Black patients (0·881, 0·809–0·959) but higher for Asian patients (1·205, 1·000–1·452). Racial/ethnic minority patients with COVID-19 had more severe disease on initial presentation than White patients. Increased mortality risk was attenuated by hospitalization among Black patients but not Asian patients, indicating that outcome disparities may be mediated by distinct factors for different groups. In addition to enacting policies to facilitate equitable access to COVID-19–related care, further analyses of disaggregated population-level COVID-19 data are needed. None.
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影响因子：
12.7
作者：
Musa, Donald;Schulz, Richard;Thomas, Stephen B.
通讯作者：
Thomas, Stephen B.
影响因子：
9.7
作者：
Guadamuz, Jenny S.;Wilder, Jocelyn R.;Qato, Dima Mazen
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Qato, Dima Mazen
DOI：
10.3390/ijerph17124322
发表时间：
2020-06-01
影响因子：
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作者：
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通讯作者：
Dabney, Kirk W.
影响因子：
39.2
作者：
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通讯作者：
Lee, Catherine
影响因子：
1.4
作者：
Chan, Kitty S.;Gaskin, Darrell J.;Thorpe, Roland J., Jr.
通讯作者：
Thorpe, Roland J., Jr.