Increased COVID-19 Infection Risk Drives Racial and Ethnic Disparities in Severe COVID-19 Outcomes.
Increased COVID-19 Infection Risk Drives Racial and Ethnic Disparities in Severe COVID-19 Outcomes.
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DOI：
10.1007/s40615-021-01205-2
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发表时间：
2023-03
影响因子：
3.9
通讯作者：
Dublin S
中科院分区：
文献类型：
--
作者：
Shortreed SM;Gray R;Akosile MA;Walker RL;Fuller S;Temposky L;Fortmann SP;Albertson-Junkans L;Floyd JS;Bayliss EA;Harrington LB;Lee MH;Dublin S
新冠肺炎的不平等现象已经有了很好的记录。我们通过评估当分析仅限于感染者时，是否仍然存在差异，来评估种族和少数民族群体中较高的严重新冠肺炎发生率是否由较高的感染率推动。我们对通过Kaiser Permanente(科罗拉多州、西北部、华盛顿州)投保的成年人进行了一项回顾性队列研究，于2020年3月至9月进行了随访。实验室结果和住院诊断代码确定了新冠肺炎患者。重度新冠肺炎定义为有创机械通气或死亡。从健康记录中提取自我报告的种族和民族、人口统计数据和医疗合并症。改进的泊松回归估计了全队列和感染个体中重症新冠肺炎的调整后相对危险度(ARR)。我们的队列包括1,052,774人，代表不同的种族和少数民族群体(例如，68,887名亚裔，41,243名黑人/非裔美国人，93,580名西班牙裔或拉丁裔/a人)。在7,399名感染者中，有442人经历了严重的新冠肺炎。在整个队列中，与非西班牙裔白人相比，亚裔、黑人/非裔美国人和西班牙裔个体的严重新冠肺炎ARR分别为2.09(95%CI：1.36，3.21)、2.02(1.39，2.93)和2.09(1.57，2.78)。在仅限于新冠肺炎携带者的分析中，除亚裔美国人外，所有ARR均接近1(ARR1.82[1.23，2.68])。这些结果表明，黑人/非裔美国人和西班牙裔人重症新冠肺炎发病率的增加是由于更高的感染率，而不是疾病进展的易感性增加。新冠肺炎的差异很可能是社会因素造成的，而不是生物因素。未来的工作应该探索亚裔美国人严重新冠肺炎风险增加的原因。我们的研究结果强调了疫苗分配公平的重要性。网上版载有补充材料，可在10.1007/s40615-021-01205-2查阅。
COVID-19 inequities have been well-documented. We evaluated whether higher rates of severe COVID-19 in racial and ethnic minority groups were driven by higher infection rates by evaluating if disparities remained when analyses were restricted to people with infection. We conducted a retrospective cohort study of adults insured through Kaiser Permanente (Colorado, Northwest, Washington), follow-up in March–September 2020. Laboratory results and hospitalization diagnosis codes identified individuals with COVID-19. Severe COVID-19 was defined as invasive mechanical ventilation or mortality. Self-reported race and ethnicity, demographics, and medical comorbidities were extracted from health records. Modified Poisson regression estimated adjusted relative risks (aRRs) of severe COVID-19 in full cohort and among individuals with infection. Our cohort included 1,052,774 individuals, representing diverse racial and ethnic minority groups (e.g., 68,887 Asian, 41,243 Black/African American, 93,580 Hispanic or Latino/a individuals). Among 7,399 infections, 442 individuals experienced severe COVID-19. In the full cohort, severe COVID-19 aRRs for Asian, Black/African American, and Hispanic individuals were 2.09 (95% CI: 1.36, 3.21), 2.02 (1.39, 2.93), and 2.09 (1.57, 2.78), respectively, compared to non-Hispanic Whites. In analyses restricted to individuals with COVID-19, all aRRs were near 1, except among Asian Americans (aRR 1.82 [1.23, 2.68]). These results indicate increased incidence of severe COVID-19 among Black/African American and Hispanic individuals is due to higher infection rates, not increased susceptibility to progression. COVID-19 disparities most likely result from social, not biological, factors. Future work should explore reasons for increased severe COVID-19 risk among Asian Americans. Our findings highlight the importance of equity in vaccine distribution. The online version contains supplementary material available at 10.1007/s40615-021-01205-2.
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影响因子：
3.9
作者：
Razjouyan J;Helmer DA;Li A;Naik AD;Amos CI;Bandi V;Sharafkhaneh A
通讯作者：
Sharafkhaneh A
影响因子：
6.3
作者：
Roux, AVD;Borrell, LN;Schultz, R
通讯作者：
Schultz, R
DOI：
10.1017/s1742058x11000130
发表时间：
2011-04
期刊：
Du Bois review : social science research on race
影响因子：
--
作者：
Gee GC;Ford CL
通讯作者：
Ford CL
影响因子：
39.2
作者：
Levey AS;Stevens LA;Schmid CH;Zhang YL;Castro AF 3rd;Feldman HI;Kusek JW;Eggers P;Van Lente F;Greene T;Coresh J;CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)
通讯作者：
CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)
DOI：
10.3122/jabfm.2021.s1.200338
发表时间：
2021-02-01
影响因子：
2.9
作者：
Khanna, Niharika;Klyushnenkova, Elena N.;Kaysin, Alexander
通讯作者：
Kaysin, Alexander