Ethnic inequalities in COVID-19 infection, hospitalisation, intensive care admission, and death: a global systematic review and meta-analysis of over 200 million study participants.
Ethnic inequalities in COVID-19 infection, hospitalisation, intensive care admission, and death: a global systematic review and meta-analysis of over 200 million study participants.
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DOI：
10.1016/j.eclinm.2023.101877
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发表时间：
2023-03
影响因子：
15.1
通讯作者：
Pareek, Manish
中科院分区：
文献类型：
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作者：
Irizar, Patricia;Pan, Daniel;Kapadia, Dharmi;Becares, Laia;Sze, Shirley;Taylor, Harry;Amele, Sarah;Kibuchi, Eliud;Divall, Pip;Gray, Laura J.;Nellums, Laura B.;Katikireddi, Srinivasa Vittal;Pareek, Manish
COVID-19加剧了现有的种族健康不平等。对于在全球少数民族群体中观察到的严重疾病和死亡的不平等是否与更大的感染风险、更差的预后或两者兼而有之有关，人们知之甚少。我们分析了COVID-19临床结果的全球数据，研究了少数民族群体与多数民族群体之间的不平等。检索了2019年12月1日至2022年10月3日期间的数据库（MEDLINE、EMBASE、EMCARE、CINAHL、科克伦图书馆），以查找报告按种族分类的COVID-19结局的原始临床数据的研究：感染、住院、重症监护室（ICU）入院和死亡率。我们使用随机效应荟萃分析评估了发病率和预后的不平等性，并使用建议评估、发展和评价分级（GRADE）评估结果的确定性。荟萃回归分析探讨了地区和时间范围（疫苗推广）对异质性的影响。PROSPERO：CRD 42021284981。纳入了77项研究，涉及超过200，000，000名参与者。与大多数白色人群相比，我们观察到来自黑人（调整后风险比[aRR]：1.78，95% CI：1.59-1.99，I2 = 99.1）、南亚人（aRR：3.00，95% CI：1.59-5.66，I2 = 99.1）、混血人（aRR：1.64，95% CI：1.02-1.67，I2 = 93.2）和其他种族人群（aRR：1.36，95% CI：1.01-1.82，I2 = 85.6）的感染检测阳性风险增加。黑人，西班牙裔和南亚人更有可能是血清阳性。在以人群为基础的研究中，黑人和西班牙裔族群以及土著人住院的风险增加;黑人、西班牙裔、南亚人、东亚人和混合族群以及土著人入住ICU的风险增加。西班牙裔、混血和土著群体的死亡风险增加。感染后的预后差异较小。在住院治疗后，南亚、东亚、黑人和混合种族组的ICU入院风险增加，混合种族组的死亡风险更大。证据的可靠性从非常低到中等不等。我们的研究表明，COVID-19健康结果存在系统性种族不平等，暴露风险存在很大差异，住院后预后存在一些差异。应对和恢复干预措施必须侧重于解决族裔不平等的驱动因素，这些因素增加了严重疾病的风险和脆弱性，包括结构性种族主义和种族歧视。文件：ES/W 000849/1。
COVID-19 has exacerbated existing ethnic inequalities in health. Little is known about whether inequalities in severe disease and deaths, observed globally among minoritised ethnic groups, relates to greater infection risk, poorer prognosis, or both. We analysed global data on COVID-19 clinical outcomes examining inequalities between people from minoritised ethnic groups compared to the ethnic majority group. Databases (MEDLINE, EMBASE, EMCARE, CINAHL, Cochrane Library) were searched from 1st December 2019 to 3rd October 2022, for studies reporting original clinical data for COVID-19 outcomes disaggregated by ethnicity: infection, hospitalisation, intensive care unit (ICU) admission, and mortality. We assessed inequalities in incidence and prognosis using random-effects meta-analyses, with Grading of Recommendations Assessment, Development, and Evaluation (GRADE) use to assess certainty of findings. Meta-regressions explored the impact of region and time-frame (vaccine roll-out) on heterogeneity. PROSPERO: CRD42021284981. 77 studies comprising over 200,000,000 participants were included. Compared with White majority populations, we observed an increased risk of testing positive for infection for people from Black (adjusted Risk Ratio [aRR]:1.78, 95% CI:1.59–1.99, I2 = 99.1), South Asian (aRR:3.00, 95% CI:1.59–5.66, I2 = 99.1), Mixed (aRR:1.64, 95% CI:1.02–1.67, I2 = 93.2) and Other ethnic groups (aRR:1.36, 95% CI:1.01–1.82, I2 = 85.6). Black, Hispanic, and South Asian people were more likely to be seropositive. Among population-based studies, Black and Hispanic ethnic groups and Indigenous peoples had an increased risk of hospitalisation; Black, Hispanic, South Asian, East Asian and Mixed ethnic groups and Indigenous peoples had an increased risk of ICU admission. Mortality risk was increased for Hispanic, Mixed, and Indigenous groups. Smaller differences were seen for prognosis following infection. Following hospitalisation, South Asian, East Asian, Black and Mixed ethnic groups had an increased risk of ICU admission, and mortality risk was greater in Mixed ethnic groups. Certainty of evidence ranged from very low to moderate. Our study suggests that systematic ethnic inequalities in COVID-19 health outcomes exist, with large differences in exposure risk and some differences in prognosis following hospitalisation. Response and recovery interventions must focus on tackling drivers of ethnic inequalities which increase exposure risk and vulnerabilities to severe disease, including structural racism and racial discrimination. :ES/W000849/1.
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影响因子：
33.9
作者：
Adjei, Stacey;Hong, Kai;Molinari, Noelle-Angelique M.;Bull-Otterson, Lara;Ajani, Umed A.;Gundlapalli, Adi, V;Harris, Aaron M.;Hsu, Joy;Kadri, Sameer S.;Starnes, Jon;Yeoman, Kristin;Boehmer, Tegan K.
通讯作者：
Boehmer, Tegan K.
DOI：
10.1017/cjn.2021.148
发表时间：
2022-07
期刊：
The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques
影响因子：
--
作者：
Chu JY;Kaliwal Y;Koh M;Chen R;Chow CM;Ko DT;Liu PP;Moe GW
通讯作者：
Moe GW
影响因子：
3.4
作者：
Consolazio, David;Murtas, Rossella;Russo, Antonio Giampiero
通讯作者：
Russo, Antonio Giampiero
影响因子：
6.3
作者：
Cifuentes, Myriam Patricia;Rodriguez-Villamizar, Laura Andrea;Fernandez-Nino, Julian Alfredo
通讯作者：
Fernandez-Nino, Julian Alfredo
DOI：
10.3961/jpmph.21.126
发表时间：
2021-05
期刊：
Journal of preventive medicine and public health = Yebang Uihakhoe chi
影响因子：
--
作者：
Allan-Blitz LT;Goldbeck C;Hertlein F;Turner I;Klausner JD
通讯作者：
Klausner JD