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罗德岛州因感染 2019 冠状病毒病(COVID-19)而住院的西班牙裔/拉丁裔患者的特征和结局:一项回顾性队列研究。

Characteristics and outcomes of Hispanic/Latinx patients with coronavirus disease 19 (COVID-19) requiring hospitalization in Rhode Island: a retrospective cohort study.

机构信息

Department of Infectious Diseases, Kaiser Permanente Northern California, Vallejo, CA.

Division of Infectious Diseases, Alpert Medical School of Brown University, Providence, RI.

出版信息

Ann Epidemiol. 2021 Jun;58:64-68. doi: 10.1016/j.annepidem.2021.03.003. Epub 2021 Mar 16.

Abstract

OBJECTIVE

Explore potential racial/ethnic differences, describe general clinical characteristic, and severe outcomes (intensive care unit [ICU] admission, mechanical ventilation [intubation], and death) between Hispanic/Latinx (hereafter: Hispanics or Latinx community) and non-Hispanic patients hospitalized with COVID-19.

METHODS

Retrospective cohort of 326 patients hospitalized with COVID-19 through April 19, 2020. Sociodemographic and hospital course data were collected and analyzed. A multivariate logistic regression analysis was implemented to examine associations.

RESULTS

Compared with non-Hispanic Whites (NHW), Hispanics were younger (53 years, median age) and had higher rates of Medicaid and less commercial/HMO/PPO coverage (P < .001). Similarly, in the age sub-grouped multivariate analysis for outcomes, Hispanics ≥65-year-old were 2.66 times more likely to be admitted to ICU (95% CI: 1.07-6.61; P = .03), and 3.67 times more likely to get intubated (95% CI: 1.29-10.36; P = .01).

CONCLUSIONS

Hospitalized Hispanic patients of ≥65-year-old with COVID-19 were more likely to have higher risk of more severe outcomes (ICU admission and intubation) compared with NHW. Hispanic patient's social determinants of health and underlying medical conditions may explain the heightened risk for severe outcomes. Further studies are necessary to more accurately identify and address health disparities in Hispanics and other vulnerable populations amidst COVID-19 and future pandemics.

摘要

目的

探讨西班牙裔/拉丁裔(以下简称西班牙裔或拉丁裔社区)与非西班牙裔住院 COVID-19 患者之间潜在的种族/民族差异、描述一般临床特征和严重结局(入住重症监护病房[ICU]、机械通气[插管]和死亡)。

方法

这是一项回顾性队列研究,纳入 2020 年 4 月 19 日前因 COVID-19 住院的 326 例患者。收集并分析社会人口统计学和住院过程数据。采用多变量逻辑回归分析来检验相关性。

结果

与非西班牙裔白人(NHW)相比,西班牙裔患者年龄更小(中位年龄 53 岁),并且有更高的医疗补助和更少的商业/HMO/PPO 覆盖(P<0.001)。同样,在按年龄分层的结局多变量分析中,≥65 岁的西班牙裔患者入住 ICU 的可能性是 NHW 的 2.66 倍(95%CI:1.07-6.61;P=0.03),插管的可能性是 NHW 的 3.67 倍(95%CI:1.29-10.36;P=0.01)。

结论

与 NHW 相比,≥65 岁的 COVID-19 住院西班牙裔患者更有可能出现更严重的结局(入住 ICU 和插管)的风险更高。西班牙裔患者的健康社会决定因素和潜在的医疗条件可能解释了严重结局风险增加的原因。有必要开展进一步的研究,以更准确地识别和解决 COVID-19 和未来大流行期间西班牙裔及其他弱势群体中的健康差距。

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