Racial and ethnic variation in COVID-19 care, treatment, and outcomes: A retrospective cohort study from the MiCOVID-19 registry.
Racial and ethnic variation in COVID-19 care, treatment, and outcomes: A retrospective cohort study from the MiCOVID-19 registry.
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DOI：
10.1371/journal.pone.0276806
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
COVID-19的结果存在种族和民族差异，但住院治疗是否解释了这种差异尚不清楚。我们试图确定COVID-19住院患者在人口统计学、合并症、住院治疗和住院结局方面的种族和民族差异。这是一项队列研究，使用MiCOVID-19，一个多中心，回顾性，协作质量改进登记，包括密歇根州38家医院的COVID-19住院患者的数据，随机选择2639名在参与MiCOVID-19登记的地点住院的成年COVID-19患者。结果包括住院死亡率、死亡年龄、重症监护病房入院以及按种族和民族划分的有创机械通气需求。基线合并症因种族和民族而异。此外，黑人患者乳酸脱氢酶、红细胞沉降率、c反应蛋白、肌酸磷酸激酶和铁蛋白水平较高。与白人患者相比，黑人患者接受地塞米松和瑞德西韦的可能性更低（4.2%对14.3%，2.2%对11.8%，p均< 0.001）。黑人（18.7%）和白人（19.6%）患者的死亡率高于亚洲（13.0%）和拉丁裔（5.9%）患者（p < 0.01）。黑人患者的平均死亡年龄（69.4±13.3岁）比白人（77.9±12.6岁）、亚洲人（77.6±6.6岁）和拉丁裔患者（77.4±15.5岁）显著降低8岁（p < 0.001）。COVID-19死亡率似乎由住院前临床和社会因素以及潜在的住院护理共同驱动。为减轻COVID-19的负担，需要制定旨在促进人口健康和公平应用循证医学治疗的政策。
Racial and ethnic disparities in COVID-19 outcomes exist, but whether in-hospital care explains this difference is not known. We sought to determine racial and ethnic differences in demographics, comorbidities, in-hospital treatments, and in-hospital outcomes of patients hospitalized with COVID-19. This was a cohort study using MiCOVID-19, a multi-center, retrospective, collaborative quality improvement registry, which included data on patients hospitalized with COVID-19 across 38 hospitals in the State of Michigan. 2,639 adult patients with COVID-19 hospitalized at a site participating in the MiCOVID-19 Registry were randomly selected. Outcomes included in-hospital mortality, age at death, intensive care unit admission, and need for invasive mechanical ventilation by race and ethnicity. Baseline comorbidities differed by race and ethnicity. In addition, Black patients had higher lactate dehydrogenase, erythrocyte sedimentation rate, C-reactive protein, creatine phosphokinase, and ferritin levels. Black patients were less likely to receive dexamethasone and remdesivir compared with White patients (4.2% vs 14.3% and 2.2% vs. 11.8%, p < 0.001 for each). Black (18.7%) and White (19.6%) patients experienced greater mortality compared with Asian (13.0%) and Latino (5.9%) patients (p < 0.01). The mean age at death was significantly lower by 8 years for Black patients (69.4 ± 13.3 years) compared with White (77.9 ± 12.6), Asian (77.6 ± 6.6), and Latino patients (77.4 ± 15.5) (p < 0.001). COVID-19 mortality appears to be driven by both pre-hospitalization clinical and social factors and potentially in-hospital care. Policies aimed at population health and equitable application of evidence-based medical therapy are needed to alleviate the burden of COVID-19.
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影响因子：
3.7
作者：
Fernando ME;Drovandi A;Golledge J
通讯作者：
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DOI：
10.1093/geronb/gbaa117
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影响因子：
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影响因子：
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Sayas A