The association of race and COVID-19 mortality
The association of race and COVID-19 mortality
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DOI：
10.1016/j.eclinm.2020.100455
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发表时间：
2020-08-01
影响因子：
15.1
通讯作者：
Bellin, Eran
中科院分区：
文献类型：
--
作者：
Golestaneh, Ladan;Neugarten, Joel;Bellin, Eran
背景：新冠肺炎死亡率对美国黑人人口的影响不成比例。为了探讨这种相关性，进行了一项队列研究。方法：我们召集了505,992名在Bronx Montefiore Health System(BMHS)接受门诊护理的患者，在18年1月1日至1月1日之间，评估了两个时间段的住院和死亡的相对风险，即COVID前时间段(1/1/20-2/15/20)和COVID时间段(3/1/20-4/15/20)。使用Logistic模型分别确定黑人和西班牙裔患者群体与白人群体的COVID检测、住院和死亡率。完成了对COVID前和COVID前时间段和种族与死亡率的交互作用的评估。结果：共有9,286/505,992名患者(1.8%)在COVID前或两者期间住院。与白人相比，黑人患者在COVID期间住院的相对风险没有增加(交互作用的p=0.12)。在冠状病毒感染前时期，与白人相比，黑人和西班牙裔的死亡几率在统计上是相等的。在COVID期间，与白人相比，黑人的调整死亡几率为1.6(95%可信区间1.2-2.0，p=0.001)。从COVID前到COVID期间，黑人死亡风险显著增加(交互作用p=0.02)。对相关临床和社会指标的调整有所减弱，但不能完全解释观察到的黑人死亡率差异。解释：英国皇家儿科学会COVID的经验表明，黑人确实有更高的死亡率，COVID不能完全用年龄、多种报告的并存和社会人口差异的现有指标来解释。(C)2020作者。爱思唯尔有限公司出版。
Background: COVID-19 mortality disproportionately affects the Black population in the United States (US). To explore this association a cohort study was undertaken.Methods: We assembled a cohort of 505,992 patients receiving ambulatory care at Bronx Montefiore Health System (BMHS) between 1/1/18 and 1/1/20 to evaluate the relative risk of hospitalization and death in two time-periods, the pre-COVID time-period (1/1/20-2/15/20) and COVID time-period (3/1/20-4/15/20). COVID testing, hospitalization and mortality were determined with the Black and Hispanic patient population compared separately to the White population using logistic modeling. Evaluation of the interaction of pre-COVID and COVID time periods and race, with respect to mortality was completed.Findings: A total of 9,286/505,992 (1.8%) patients were hospitalized during either or both pre-COVID or COVID periods. Compared to Whites the relative risk of hospitalization of Black patients did not increase in the COVID period (p for interaction=0.12). In the pre- COVID period, compared to Whites, the odds of death for Blacks and Hispanics adjusted for comorbidity was statistically equivalent. In the COVID period compared to Whites the adjusted odds of death for Blacks was 1.6 (95% CI 1.2-2.0, p = 0.001). There was a significant increase in Black mortality risk from pre-COVID to COVID periods (p for interaction=0.02). Adjustment for relevant clinical and social indices attenuated but did not fully explain the observed difference in Black mortality.Interpretation: The BMHS COVID experience demonstrates that Blacks do have a higher mortality with COVID incompletely explained by age, multiple reported comorbidities and available metrics of sociodemographic disparity. (C) 2020 The Authors. Published by Elsevier Ltd.