Multivariate Analysis of Black Race and Environmental Temperature on COVID-19 in the US
Multivariate Analysis of Black Race and Environmental Temperature on COVID-19 in the US
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DOI：
10.1016/j.amjms.2020.06.015
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发表时间：
2020-10-01
影响因子：
3.1
通讯作者：
Choudhri, Tanvir F.
中科院分区：
文献类型：
--
作者：
Li, Adam Y.;Hannah, Theodore C.;Choudhri, Tanvir F.
背景资料：人们对环境温度和种族作为冠状病毒疾病19（COVID-19）感染和死亡率的调节剂非常感兴趣。然而，在美国，种族和温度与其他各种健康、合并症和环境影响的社会决定因素相关，这些因素可能导致显著的影响。本研究调查了种族和环境温度对美国各县COVID-19发病率和死亡率的独立影响。方法：收集了美国所有各县COVID-19和风险因素的数据。分析包括至少有50例COVID-19病例的661个县和至少有10例死亡的217个县。病例/100，000人的上下四分位数和死亡/100，000人的一半通过t检验进行比较。结果：多变量回归分析显示，黑人是COVID-19病例增加（OR=1.22，95%CI：1.09-1.40，P=0.001）和死亡的危险因素，与合并症、贫困、获得医疗保健和其他危险因素无关。较高的环境温度独立地减少了病例量（OR=0.81，95%CI：0.71-0.91，P=0.0009），但没有死亡。结论：较高的环境温度与COVID-19病例减少相关，但这种益处尚未出现在死亡率模型中。黑人种族是COVID-19病例和死亡增加的独立风险因素。因此，许多提出的黑人种族可能增加COVID-19风险的机制，如社会经济和医疗保健相关的倾向，不足以解释这种健康差异的全部程度。
Background: There has been much interest in environmental temperature and race as modulators of Coronavirus disease-19 (COVID-19) infection and mortality. However, in the United States race and temperature correlate with various other social determinants of health, comorbidities, and environmental influences that could be responsible for noted effects. This study investigates the independent effects of race and environmental temperature on COVID-19 incidence and mortality in United States counties.Methods: Data on COVID-19 and risk factors in all United States counties was collected. 661 counties with at least 50 COVID-19 cases and 217 with at least 10 deaths were included in analyses. Upper and lower quartiles for cases/100,000 people and halves for deaths/100,000 people were compared with t-tests. Adjusted linear and logistic regression analyses were performed to evaluate the independent effects of race and environmental temperature.Results: Multivariate regression analyses demonstrated Black race is a risk factor for increased COVID-19 cases (OR=1.22, 95% CI: 1.09-1.40, P=0.001) and deaths independent of comorbidities, poverty, access to health care, and other risk factors. Higher environmental temperature independently reduced caseload (OR=0.81, 95% CI: 0.71-0.91, P=0.0009), but not deaths.Conclusions: Higher environmental temperatures correlated with reduced COVID-19 cases, but this benefit does not yet appear in mortality models. Black race was an independent risk factor for increased COVID-19 cases and deaths. Thus, many proposed mechanisms through which Black race might increase risk for COVID-19, such as socioeconomic and healthcare-related predispositions, are inadequate in explaining the full magnitude of this health disparity.