Department of Surgery, Tulane University School of Medicine, New Orleans, LA.
University of Iowa Hospitals and Clinics, Iowa City, IA.
Ann Surg. 2020 Sep 1;272(3):e187-e190. doi: 10.1097/SLA.0000000000004185.
Our study aims to explore the differential impact of this pandemic on clinical presentations and outcomes in African Americans (AAs) compared to white patients.
AAs have worse outcomes compared to whites while facing heart diseases, stroke, cancer, asthma, influenza and pneumonia, diabetes, and HIV/AIDS. However, there is no current study to show the impact of COVID-19 pandemic on the AA communities.
This is a retrospective study that included patients with laboratory-confirmed COVID-19 from 2 tertiary centers in New Orleans, LA. Clinical and laboratory data were collected. Multivariate analyses were performed to identify the risk factors associated with adverse events.
A total of 157 patients were identified. Of these, 134 (77%) were AAs, whereas 23.4% of patients were Whites. Interestingly, AA were younger, with a mean age of 63 ± 13.4 compared to 75.7 ± 23 years in Whites (P < 0.001). Thirty-seven patients presented with no insurance, and 34 of them were AA. SOFA Score was significantly higher in AA (2.57 ± 2.1) compared to White patients (1.69 ± 1.7), P = 0.041. Elevated SOFA score was associated with higher odds for intubation (odds ratio = 1.6, 95% confidence interval = 1.32-1.93, P < 0.001). AA had more prolonged length of hospital stays (11.1 ± 13.4 days vs 7.7 ± 23 days) than in Whites, P = 0.01.
AAs present with more advanced disease and eventually have worse outcomes from COVID-19 infection. Future studies are warranted for further investigations that should impact the need for providing additional resources to the AA communities.
本研究旨在探讨与白人患者相比,这场大流行对非裔美国人(AA)的临床表现和结局的不同影响。
AA 在面临心脏病、中风、癌症、哮喘、流感和肺炎、糖尿病以及 HIV/AIDS 时,其预后比白人更差。然而,目前尚无研究表明 COVID-19 大流行对 AA 社区的影响。
这是一项回顾性研究,纳入了来自新奥尔良 2 家 3 级医疗机构的实验室确诊 COVID-19 患者。收集了临床和实验室数据。进行了多变量分析,以确定与不良事件相关的危险因素。
共纳入 157 例患者。其中,134 例(77%)为 AA,23.4%的患者为白人。有趣的是,AA 更年轻,平均年龄为 63 ± 13.4 岁,而白人患者为 75.7 ± 23 岁(P < 0.001)。37 例患者无保险,其中 34 例为 AA。AA 的 SOFA 评分明显高于白人患者(2.57 ± 2.1 比 1.69 ± 1.7,P = 0.041)。SOFA 评分升高与插管的可能性更高相关(比值比= 1.6,95%置信区间= 1.32-1.93,P < 0.001)。AA 的住院时间更长(11.1 ± 13.4 天比 7.7 ± 23 天),P = 0.01。
AA 出现更晚期疾病,最终 COVID-19 感染的结局更差。需要进一步研究,以应对为 AA 社区提供额外资源的需求。