Racial differences in COVID-19 severity associated with history of substance use disorders and overdose: Findings from multi-site electronic health records in New York City.
Racial differences in COVID-19 severity associated with history of substance use disorders and overdose: Findings from multi-site electronic health records in New York City.
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DOI：
10.1016/j.ypmed.2023.107533
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发表时间：
2023-07
影响因子：
5.1
通讯作者：
Krawczyk, Noa
中科院分区：
文献类型：
--
作者：
Allen, Bennett;Basaraba, Cale;Corbeil, Thomas;Rivera, Bianca D.;Levin, Frances R.;Martinez, Diana M.;Schultebraucks, Katharina;Henry, Brandy F.;Pincus, Harold A.;Arout, Caroline;Krawczyk, Noa
物质使用障碍（SUD）与COVID-19结局恶化的风险增加有关。同样，与白色患者相比，种族/少数民族患者患严重COVID-19疾病的风险更大。提供者应了解种族和民族作为SUD患者中COVID-19严重程度的影响因素的作用。这项回顾性队列研究评估了患者人种/种族作为有SUD和药物过量病史的患者中重度COVID-19疾病风险的影响因素。我们使用了来自纽约市五个医疗保健系统的116，471名于2020年3月至2021年2月期间遭遇COVID-19的成年患者的合并电子健康记录数据。暴露为SUD和药物过量的患者病史。结果包括COVID-19住院和随后的COVID-19相关通气、急性肾衰竭、败血症和死亡的风险。风险因素包括患者年龄、性别和种族/民族，以及与COVID-19严重程度相关的医学合并症。我们测试了SUD和患者种族/民族之间对COVID-19结局的相互作用。结果显示，与非西班牙裔白色患者相比，非西班牙裔黑人、西班牙裔/拉丁裔和亚洲/太平洋岛民患者的所有不良COVID-19结局的患病率更高。过去一年的酒精（OR 1.24 [1.01-1.53]）和阿片类药物使用障碍（OR 1.91 [1.46-2.49]）以及用药过量史（OR 4.45 [3.62-5.46]）可预测COVID-19死亡率以及其他不良COVID-19结局。在SUD患者中，不同人种/种族组患者的结局风险存在显著差异。研究结果表明，提供者应考虑脆弱性的多个方面，以充分管理SUD人群中的COVID-19疾病。
Substance use disorders (SUD) are associated with increased risk of worse COVID-19 outcomes. Likewise, racial/ethnic minority patients experience greater risk of severe COVID-19 disease compared to white patients. Providers should understand the role of race and ethnicity as an effect modifier on COVID-19 severity among individuals with SUD. This retrospective cohort study assessed patient race/ethnicity as an effect modifier of the risk of severe COVID-19 disease among patients with histories of SUD and overdose. We used merged electronic health record data from 116,471 adult patients with a COVID-19 encounter between March 2020 and February 2021 across five healthcare systems in New York City. Exposures were patient histories of SUD and overdose. Outcomes were risk of COVID-19 hospitalization and subsequent COVID-19-related ventilation, acute kidney failure, sepsis, and mortality. Risk factors included patient age, sex, and race/ethnicity, as well as medical comorbidities associated with COVID-19 severity. We tested for interaction between SUD and patient race/ethnicity on COVID-19 outcomes. Findings showed that Non-Hispanic Black, Hispanic/Latino, and Asian/Pacific Islander patients experienced a higher prevalence of all adverse COVID-19 outcomes compared to non-Hispanic white patients. Past-year alcohol (OR 1.24 [1.01–1.53]) and opioid use disorders (OR 1.91 [1.46–2.49]), as well as overdose history (OR 4.45 [3.62–5.46]), were predictive of COVID-19 mortality, as well as other adverse COVID-19 outcomes. Among patients with SUD, significant differences in outcome risk were detected between patients of different race/ethnicity groups. Findings indicate that providers should consider multiple dimensions of vulnerability to adequately manage COVID-19 disease among populations with SUDs.
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影响因子：
13.8
作者：
Cartus AR;Li Y;Macmadu A;Goedel WC;Allen B;Cerdá M;Marshall BDL
通讯作者：
Marshall BDL
影响因子：
4.2
作者：
Hasin DS;Fink DS;Olfson M;Saxon AJ;Malte C;Keyes KM;Gradus JL;Cerdá M;Maynard CC;Keyhani S;Martins SS;Livne O;Mannes ZL;Sherman SE;Wall MM
通讯作者：
Wall MM
DOI：
10.1016/j.cjca.2020.11.010
发表时间：
2021-09
期刊：
The Canadian journal of cardiology
影响因子：
--
作者：
Austin PC;White IR;Lee DS;van Buuren S
通讯作者：
van Buuren S
影响因子：
6
作者：
Krawczyk，Noa;Rivera，Bianca D.;Martinez，Diana
通讯作者：
Martinez，Diana
影响因子：
5.7
作者：
Levine DM;Lipsitz SR;Co Z;Song W;Dykes PC;Samal L
通讯作者：
Samal L