U.S. population at increased risk of severe illness from COVID-19.
U.S. population at increased risk of severe illness from COVID-19.
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DOI：
10.1016/j.ajpc.2021.100156
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发表时间：
2021-06
影响因子：
4.1
通讯作者：
Khera A
中科院分区：
文献类型：
--
作者：
Ajufo E;Rao S;Navar AM;Pandey A;Ayers CR;Khera A
美国疾病控制和预防中心（CDC）认识到，老年人和患有某些疾病的个人感染严重COVID-19的风险增加。了解有严重感染风险的人口比例，包括心脏病患者，可以帮助目前的疫苗战略工作。使用2015-2018年国家健康和营养检查调查（NHANES）的数据，我们估计了11种风险增加的疾病中的8种的加权患病率。（包括年龄≥65岁）≥18岁的美国成年人（N = 10，581），并将这些结果外推至2.338亿美国≥18岁成人人群，以及由种族/民族、教育、收入和心脏病史定义的总体人群的亚组。估计有1.761亿人（占美国成年人的75.4%）至少有一种风险增加的疾病，40.3% ≥2种，18.5% ≥3种。据估计，约有1.29亿年龄<65岁的成年人（69.2%）的风险也在增加。与白人相比，黑人在总人口中的比例相似（78.0比75.6%，p>0.05）和年轻人群中的西班牙裔（70.8%对68.4%）估计风险增加。相反，据估计，在总人口和年轻人口中，受教育程度和收入水平较低的人中有更大比例的人面临更大的风险。此外，估计有620万人（14.5%）患有心脏病。在这些患者中，几乎所有患者都有至少一个额外的CDC风险因素（97.9%），大多数患者有≥2个或≥3个风险因素（分别为83.8%和58.5%）。随着疫苗接种策略的探索，这些结果表明，根据CDC标准，美国超过75%的成年人将被视为严重COVID-19感染的风险增加。风险因素患病率本身可能不足以反映风险的总体情况，特别是在黑人和西班牙裔种族/族裔群体以及心脏病患者中。
The U.S. Centers for Disease Control and Prevention (CDC) recognizes that older adults and individuals with certain medical conditions are at increased risk of severe COVID-19 infection. Understanding the proportion of the population at risk of severe infection, including among those with heart disease, could assist current vaccine strategy efforts. Using data from the 2015-2018 National Health and Nutrition Examination Survey (NHANES), we estimated the weighted prevalence of any of eight of eleven increased-risk conditions (including age ≥65) in U.S. adults aged ≥18 (N = 10,581) and extrapolated these results to a population of 233.8 million U.S. adults ≥18, and subgroups from the overall population defined by race/ethnicity, education, income and history of heart disease. An estimated 176.1 million individuals representing 75.4% of U.S. adults had at least one increased-risk condition, 40.3% ≥2 and, 18.5% ≥3 conditions. Approximately 129 million adults aged <65 (69.2%) were also estimated to be at increased-risk. Compared to Whites, similar proportions of Blacks in the overall population (78.0 vs. 75.6%, p>0.05) and Hispanics in the younger population (70.8 vs 68.4%) were estimated to be at increased-risk. Conversely, a greater proportion of individuals with lower education and income levels were estimated to be at increased-risk both in the overall and younger population. In addition, an estimated 6.2 million individuals (14.5%) had heart disease. Among these, virtually all had at least one additional CDC risk factor (97.9%) and most had ≥2 or ≥3 risk factors (83.8% and 58.5%, respectively). As vaccination strategies are being explored, these results demonstrate that >75% of adults in the U.S. would be considered at increased-risk for severe COVID-19 infection by CDC criteria. Risk factor prevalence alone may not adequately capture the totality of risk, particularly among Black and Hispanic racial/ethnic groups and those with heart disease.
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影响因子：
13.8
作者：
Ioannou GN;Locke E;Green P;Berry K;O'Hare AM;Shah JA;Crothers K;Eastment MC;Dominitz JA;Fan VS
通讯作者：
Fan VS
影响因子：
39.2
作者：
Selvin E;Wang D;Lee AK;Bergenstal RM;Coresh J
通讯作者：
Coresh J
DOI：
10.15585/mmwr.mm6929a1
发表时间：
2020-07-24
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Razzaghi, Hilda;Wang, Yan;Greenlund, Kurt J
通讯作者：
Greenlund, Kurt J
影响因子：
4.9
作者：
Yun, S;Zhu, BP;Brownson, RC
通讯作者：
Brownson, RC
影响因子：
39.2
作者：
Murphy D;McCulloch CE;Lin F;Banerjee T;Bragg-Gresham JL;Eberhardt MS;Morgenstern H;Pavkov ME;Saran R;Powe NR;Hsu CY;Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team
通讯作者：
Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team