Suppr超能文献

新奥尔良队列中新冠肺炎住院患者基于种族的临床特征与结局

Clinical Characteristics and Outcomes Based on Race of Hospitalized Patients With COVID-19 in a New Orleans Cohort.

作者信息

Silver Victoria, Chapple Andrew G, Feibus Allison H, Beckford Jeremy, Halapin Natalie A, Barua Delphi, Gordon Angellica, Baumgartner Will, Vignes Seth, Clark Cullen, Kamboj Sanjay, Lim Stephen C, Mackey Scott P, Seal Paula S, Kanter Joseph M, Bell Caryn, Clement Meredith E

机构信息

Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.

Biostatistics Program, LSUHSC School of Public Health, New Orleans, Louisiana, USA.

出版信息

Open Forum Infect Dis. 2020 Aug 13;7(9):ofaa339. doi: 10.1093/ofid/ofaa339. eCollection 2020 Sep.

Abstract

BACKGROUND

In Louisiana, deaths related to COVID-19 have disproportionately occurred in Black persons. Granular data are needed to better understand inequities and develop prevention strategies to mitigate further impact on Black communities.

METHODS

We conducted a retrospective study of patients admitted to an urban safety net hospital in New Orleans, Louisiana, with reactive SARS-CoV-2 testing from March 9 to 31, 2020. Clinical characteristics of Black and other racial/ethnic group patients were compared using Wilcoxon rank-sum test and Fisher exact tests. The relationship between race and outcome was assessed using day 14 status on an ordinal scale.

RESULTS

This study included 249 patients. The median age was 59, 44% were male, and 86% were age ≥65 years or had ≥1 comorbidity. Overall, 87% were Black, relative to 55% Black patients typically hospitalized at our center. Black patients had longer symptom duration at presentation (6.41 vs 5.88 days;  = .05) and were more likely to have asthma ( = .008) but less likely to have dementia ( = .002). There were no racial differences in initial respiratory status or laboratory values except for higher lactate dehydrogenase in Black patients. Patient age and initial oxygen requirement, but not race (adjusted proportional odds ratio, 0.92; 95% CI, 0.70-1.20), were associated with worse day 14 outcomes.

CONCLUSIONS

Our results demonstrate minor racial differences in comorbidities or disease severity at presentation, and day 14 outcomes were not different between groups. However, Black patients were disproportionately represented in hospitalizations, suggesting that prevention efforts should include strategies to limit SARS-CoV-2 exposures and transmission in Black communities as one step toward reducing COVID-19-related racial inequities.

摘要

背景

在路易斯安那州,与新型冠状病毒肺炎(COVID-19)相关的死亡病例在黑人中所占比例过高。需要详细数据以更好地了解不平等现象,并制定预防策略以减轻对黑人社区的进一步影响。

方法

我们对2020年3月9日至31日在路易斯安那州新奥尔良市一家城市安全网医院收治的、接受过反应性严重急性呼吸综合征冠状病毒2(SARS-CoV-2)检测的患者进行了一项回顾性研究。使用Wilcoxon秩和检验和Fisher精确检验比较黑人和其他种族/族裔患者的临床特征。使用第14天的序数量表评估种族与结局之间的关系。

结果

本研究纳入了249例患者。中位年龄为59岁,44%为男性,86%年龄≥65岁或患有≥1种合并症。总体而言,87%为黑人,而在我们中心住院的患者中黑人患者通常占55%。黑人患者就诊时症状持续时间更长(6.41天对5.88天;P = 0.05),更有可能患有哮喘(P = 0.008),但患痴呆症的可能性较小(P = 0.002)。除黑人患者乳酸脱氢酶水平较高外,初始呼吸状态或实验室检查值无种族差异。患者年龄和初始吸氧需求与第14天结局较差相关,但种族无关(调整后的比例优势比为0.92;95%置信区间为0.70 - 1.20)。

结论

我们的结果表明,就诊时合并症或疾病严重程度存在微小的种族差异,且两组第14天的结局无差异。然而,住院患者中黑人所占比例过高,这表明预防措施应包括限制SARS-CoV-2在黑人社区暴露和传播的策略,作为减少与COVID-19相关的种族不平等的一步。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/293b/7462365/4a6b969ddff2/ofaa339f0001.jpg

相似文献

引用本文的文献

5
Host variations in SARS-CoV-2 infection.严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染中的宿主差异。
Turk J Biol. 2021 Aug 30;45(4):404-424. doi: 10.3906/biy-2104-67. eCollection 2021.
8

本文引用的文献

2
Assessing differential impacts of COVID-19 on black communities.评估 COVID-19 对黑人群体的差异化影响。
Ann Epidemiol. 2020 Jul;47:37-44. doi: 10.1016/j.annepidem.2020.05.003. Epub 2020 May 14.

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验