Racial Disparities in Incidence and Outcomes Among Patients With COVID-19.
Racial Disparities in Incidence and Outcomes Among Patients With COVID-19.
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DOI：
10.1001/jamanetworkopen.2020.21892
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发表时间：
2020-09-01
影响因子：
13.8
通讯作者：
Pezzin LE
中科院分区：
文献类型：
--
作者：
Muñoz-Price LS;Nattinger AB;Rivera F;Hanson R;Gmehlin CG;Perez A;Singh S;Buchan BW;Ledeboer NA;Pezzin LE
在控制年龄、性别、社会经济地位和合并症后，种族与2019冠状病毒病（COVID-19）之间是否存在关联？在这项针对2595名患者的横断面研究中，COVID-19检测阳性与黑人种族、男性和年龄60岁或以上相关。黑人种族和贫困与住院有关，但只有贫困与重症监护室入院有关。这项研究的结果表明，在威斯康星州密尔沃基的COVID-19大流行的最初几周，黑人种族与COVID-19检测呈阳性以及随后需要住院治疗有关，但只有贫困与重症监护室入院有关。这项横断面研究描述了种族与2019冠状病毒病（COVID-19）发病率和结局的相关性，同时控制了年龄，性别，社会经济地位和合并症。最初的公共卫生数据显示，黑人种族可能是2019冠状病毒病（COVID-19）后果恶化的风险因素。在控制年龄、性别、社会经济地位和合并症的同时，描述种族与COVID-19发病率和结局的相关性。这项横断面研究包括2595名连续的成年人，他们于2020年3月12日至3月31日在威斯康星州（密尔沃基）的Froedtert健康与医学院接受COVID-19检测，该学院是威斯康星州最大的学术系统，拥有879张住院床位（其中128张是重症监护病房床位）。种族（黑人vs白色，夏威夷原住民或太平洋岛民，美洲原住民或阿拉斯加原住民，亚洲人或未知）。主要结局包括COVID-19阳性、住院、入住重症监护室、机械通气和死亡。测量和测试的其他独立变量包括社会经济地位、性别和合并症。采用逆转录聚合酶链反应（RT-PCR）方法检测SARS冠状病毒2型（SARS-CoV-2）。共纳入2595例患者。平均（SD）年龄为53.8（17.5）岁，978例（37.7%）为男性，785例（30.2%）为非洲裔美国人患者。在369名COVID-19检测呈阳性的患者（14.2%）中，170名（46.1%）为男性，148名（40.1%）年龄在60岁或以上，218名（59.1%）为非洲裔美国人。阳性检测与黑人种族（比值比[OR]，5.37; 95%CI，3.94-7.29; P = 0.001）、男性（OR，1.55; 95%CI，1.21-2.00; P = 0.001）和年龄60岁或以上（OR，2.04; 95%CI，1.53-2.73; P = 0.001）相关。居住地的邮政编码解释了队列中COVID-19阳性总体方差的79%（ρ = 0.79; 95%CI，0.58-0.91）。调整居住地邮政编码后，黑人（OR，1.85; 95%CI，1.00-3.65; P = 0.04）和贫困（OR，3.84; 95%CI，1.20-12.30; P = 0.02）与住院相关。贫困（OR，3.58; 95%CI，1.08-11.80; P = 0.04）而非黑人（OR，1.52; 95%CI，0.75-3.07; P = 0.24）与入住重症监护室相关。总体而言，报告了20例（17.2%）与COVID-19相关的死亡。临产时呼吸急促（OR，10.67; 95% CI，1.52-25.54; P = .02），体重指数较高（每单位体重指数的OR，1.19; 95%CI，1.05-1.35; P = .006），年龄≥ 60岁（OR，22.79; 95% CI，3.38-53.81; P = .001）与死亡可能性增加相关。在这项对中西部一个大型学术卫生系统中接受COVID-19检测的成年人进行的横断面研究中，COVID-19阳性与黑人种族相关。在COVID-19患者中，种族和贫困都与更高的住院风险相关，但只有贫困与更高的重症监护室入院风险相关。这些发现有助于针对COVID-19发病率和结果的种族差异制定缓解策略。
Is there an association between race and coronavirus disease 2019 (COVID-19) after controlling for age, sex, socioeconomic status, and comorbidities? In this cross-sectional study of 2595 patients, positive COVID-19 tests were associated with Black race, male sex, and age 60 years or older. Black race and poverty were associated with hospitalization, but only poverty was associated with intensive care unit admission. The results of this study indicate that in the first weeks of the COVID-19 pandemic in Milwaukee, Wisconsin, Black race was associated with a positive COVID-19 test and the subsequent need for hospitalization, but only poverty was associated with intensive care unit admission. This cross-sectional study characterizes the association of race with incidence and outcomes of coronavirus disease 2019 (COVID-19), while controlling for age, sex, socioeconomic status, and comorbidities. Initial public health data show that Black race may be a risk factor for worse outcomes of coronavirus disease 2019 (COVID-19). To characterize the association of race with incidence and outcomes of COVID-19, while controlling for age, sex, socioeconomic status, and comorbidities. This cross-sectional study included 2595 consecutive adults tested for COVID-19 from March 12 to March 31, 2020, at Froedtert Health and Medical College of Wisconsin (Milwaukee), the largest academic system in Wisconsin, with 879 inpatient beds (of which 128 are intensive care unit beds). Race (Black vs White, Native Hawaiian or Pacific Islander, Native American or Alaska Native, Asian, or unknown). Main outcomes included COVID-19 positivity, hospitalization, intensive care unit admission, mechanical ventilation, and death. Additional independent variables measured and tested included socioeconomic status, sex, and comorbidities. Reverse transcription polymerase chain reaction assay was used to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A total of 2595 patients were included. The mean (SD) age was 53.8 (17.5) years, 978 (37.7%) were men, and 785 (30.2%) were African American patients. Of the 369 patients (14.2%) who tested positive for COVID-19, 170 (46.1%) were men, 148 (40.1%) were aged 60 years or older, and 218 (59.1%) were African American individuals. Positive tests were associated with Black race (odds ratio [OR], 5.37; 95% CI, 3.94-7.29; P = .001), male sex (OR, 1.55; 95% CI, 1.21-2.00; P = .001), and age 60 years or older (OR, 2.04; 95% CI, 1.53-2.73; P = .001). Zip code of residence explained 79% of the overall variance in COVID-19 positivity in the cohort (ρ = 0.79; 95% CI, 0.58-0.91). Adjusting for zip code of residence, Black race (OR, 1.85; 95% CI, 1.00-3.65; P = .04) and poverty (OR, 3.84; 95% CI, 1.20-12.30; P = .02) were associated with hospitalization. Poverty (OR, 3.58; 95% CI, 1.08-11.80; P = .04) but not Black race (OR, 1.52; 95% CI, 0.75-3.07; P = .24) was associated with intensive care unit admission. Overall, 20 (17.2%) deaths associated with COVID-19 were reported. Shortness of breath at presentation (OR, 10.67; 95% CI, 1.52-25.54; P = .02), higher body mass index (OR per unit of body mass index, 1.19; 95% CI, 1.05-1.35; P = .006), and age 60 years or older (OR, 22.79; 95% CI, 3.38-53.81; P = .001) were associated with an increased likelihood of death. In this cross-sectional study of adults tested for COVID-19 in a large midwestern academic health system, COVID-19 positivity was associated with Black race. Among patients with COVID-19, both race and poverty were associated with higher risk of hospitalization, but only poverty was associated with higher risk of intensive care unit admission. These findings can be helpful in targeting mitigation strategies for racial disparities in the incidence and outcomes of COVID-19.
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影响因子：
6.9
作者：
Burroughs, Valentine J.;Nonas, Cathy;Burton, Steven L.
通讯作者：
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DOI：
10.1001/jama.2020.6775
发表时间：
2020-01-01
期刊：
JAMA, Journal of the American Medical Association
影响因子：
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影响因子：
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