Disparities in COVID-19 Outcomes by Race, Ethnicity, and Socioeconomic Status: A Systematic-Review and Meta-analysis.
Disparities in COVID-19 Outcomes by Race, Ethnicity, and Socioeconomic Status: A Systematic-Review and Meta-analysis.
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Covid-19在种族，种族和社会经济地位的结果中的差异：系统评价和荟萃分析。
DOI：
10.1001/jamanetworkopen.2021.34147
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发表时间：
2021-11-01
影响因子：
13.8
通讯作者：
Ongkeko WM
中科院分区：
文献类型：
--
作者：
Magesh S;John D;Li WT;Li Y;Mattingly-App A;Jain S;Chang EY;Ongkeko WM
美国基于种族和民族的新冠肺炎结果差异是否与社会经济特征有关？在这项对68项研究中430万名患者的系统性回顾和荟萃分析中，非洲裔、西班牙裔和亚裔美国人比白人有更高的新冠肺炎阳性风险和重症监护病房入院风险，但死亡率更低。在种族和少数民族群体中，社会经济差异和临床护理质量与新冠肺炎死亡率和发病率相关。在这项研究中，种族和少数民族成员的新冠肺炎阳性率和疾病严重性高于白人人口；这些发现对于制定公共卫生决策非常重要，特别是对于生活在社会经济贫困社区的个人。这是一篇系统的综述和荟萃分析，考察了种族、民族、新冠肺炎结果和社会经济决定因素之间的关联。新冠肺炎对种族和少数民族群体的影响不成比例，种族和民族与疾病的严重程度有关。然而，社会经济决定因素与新冠肺炎结果中的种族差异之间的关联仍不清楚。评估种族和族裔与新冠肺炎结局的关联，并检验种族、族裔、新冠肺炎结局和社会经济决定因素之间的关联。针对2020年1月1日至2021年1月6日发表的研究，系统搜索PubMed、MedRxiv、BioRxiv、Embase和世界卫生组织新冠肺炎数据库。报告了种族和民族与新冠肺炎阳性率、疾病严重性和社会经济地位之间关系的研究被纳入并由2名独立评价者进行筛选。质量得分不令人满意的研究被排除在外。总体而言，最初确定的研究中符合选择标准的不到1%(0.47%)。遵循了系统审查和荟萃分析(PRISMA)指南的首选报告项目。使用调整和未调整的风险比(RR)和优势比(OR)、合并患病率和荟萃回归来评估相关性。使用随机效应模型汇集数据。主要测量RRS、ORS和综合患病率。这项荟萃分析纳入了68项研究中的4名 318名 患者。总体而言， 933例(8.6%)为非裔美国人，9082例(0.2%)为印第安人或阿拉斯加原住民，101例 793(2.4%)为亚裔，851例 392为拉美裔(19.7%)，7,417例(0.2%)为太平洋岛民，1例 037 996(24.0%)为白人，269例 040(6.2%)为多种族或其他种族。在年龄和性别调整的分析中，非洲裔美国人(RR，3.54；95%CI，1.38-9.07；P = .008)和西班牙裔个人(RR，4.68；95%CI，1.28-17.20；P = .02)最有可能检测出新冠肺炎阳性。亚裔美国人入院重症监护病房的风险最高(RR，1.93；95%CI，1.6-2.34，P <； .001)。亚裔美国人和西班牙裔美国人的面积剥夺指数与死亡率呈正相关(P <； .001)。在拉美裔(P <； .001)和非裔美国人(P <； .001)中，获得临床护理的机会减少与新冠肺炎阳性率呈正相关。在这项研究中，种族和少数民族成员患新冠肺炎阳性和疾病严重程度的风险更高。此外，在种族和少数民族人口中，社会经济决定因素与新冠肺炎的结果密切相关。
Are race and ethnicity–based COVID-19 outcome disparities in the United States associated with socioeconomic characteristics? In this systematic review and meta-analysis of 4.3 million patients from 68 studies, African American, Hispanic, and Asian American individuals had a higher risk of COVID-19 positivity and ICU admission but lower mortality rates than White individuals. Socioeconomic disparity and clinical care quality were associated with COVID-19 mortality and incidence in racial and ethnic minority groups. In this study, members of racial and ethnic minority groups had higher rates of COVID-19 positivity and disease severity than White populations; these findings are important for informing public health decisions, particularly for individuals living in socioeconomically deprived communities. This systematic review and meta-analysis examines the association between race, ethnicity, COVID-19 outcomes, and socioeconomic determinants. COVID-19 has disproportionately affected racial and ethnic minority groups, and race and ethnicity have been associated with disease severity. However, the association of socioeconomic determinants with racial disparities in COVID-19 outcomes remains unclear. To evaluate the association of race and ethnicity with COVID-19 outcomes and to examine the association between race, ethnicity, COVID-19 outcomes, and socioeconomic determinants. A systematic search of PubMed, medRxiv, bioRxiv, Embase, and the World Health Organization COVID-19 databases was performed for studies published from January 1, 2020, to January 6, 2021. Studies that reported data on associations between race and ethnicity and COVID-19 positivity, disease severity, and socioeconomic status were included and screened by 2 independent reviewers. Studies that did not have a satisfactory quality score were excluded. Overall, less than 1% (0.47%) of initially identified studies met selection criteria. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Associations were assessed using adjusted and unadjusted risk ratios (RRs) and odds ratios (ORs), combined prevalence, and metaregression. Data were pooled using a random-effects model. The main measures were RRs, ORs, and combined prevalence values. A total of 4 318 929 patients from 68 studies were included in this meta-analysis. Overall, 370 933 patients (8.6%) were African American, 9082 (0.2%) were American Indian or Alaska Native, 101 793 (2.4%) were Asian American, 851 392 identified as Hispanic/Latino (19.7%), 7417 (0.2%) were Pacific Islander, 1 037 996 (24.0%) were White, and 269 040 (6.2%) identified as multiracial and another race or ethnicity. In age- and sex-adjusted analyses, African American individuals (RR, 3.54; 95% CI, 1.38-9.07; P = .008) and Hispanic individuals (RR, 4.68; 95% CI, 1.28-17.20; P = .02) were the most likely to test positive for COVID-19. Asian American individuals had the highest risk of intensive care unit admission (RR, 1.93; 95% CI, 1.60-2.34, P < .001). The area deprivation index was positively correlated with mortality rates in Asian American and Hispanic individuals (P < .001). Decreased access to clinical care was positively correlated with COVID-19 positivity in Hispanic individuals (P < .001) and African American individuals (P < .001). In this study, members of racial and ethnic minority groups had higher risks of COVID-19 positivity and disease severity. Furthermore, socioeconomic determinants were strongly associated with COVID-19 outcomes in racial and ethnic minority populations.
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影响因子：
3.1
作者：
Chilimuri, Sridhar;Sun, Haozhe;Nayudu, Suresh K.
通讯作者：
Nayudu, Suresh K.
影响因子：
2.7
作者：
Abrams, Mark P.;Wan, Elaine Y.;Saluja, Deepak
通讯作者：
Saluja, Deepak
影响因子：
3.7
作者：
Bassett IV;Triant VA;Bunda BA;Selvaggi CA;Shinnick DJ;He W;Lu F;Porneala BC;Cao T;Lubitz SA;Meigs JB;Hsu J;Foulkes AS
通讯作者：
Foulkes AS
DOI：
10.15585/mmwr.mm6927a3
发表时间：
2020-07-10
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Hsu HE;Ashe EM;Silverstein M;Hofman M;Lange SJ;Razzaghi H;Mishuris RG;Davidoff R;Parker EM;Penman-Aguilar A;Clarke KEN;Goldman A;James TL;Jacobson K;Lasser KE;Xuan Z;Peacock G;Dowling NF;Goodman AB
通讯作者：
Goodman AB
影响因子：
39.2
作者：
Garibaldi, Brian T.;Fiksel, Jacob;Gupta, Amita
通讯作者：
Gupta, Amita