Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Syst Rev. 2021 Jul 2;10(1):196. doi: 10.1186/s13643-021-01749-8.
The COVID-19 pandemic caused by SARS-CoV-2 has highlighted consistent inequities in incidence, disease severity, and mortality across racial and ethnic minority populations in the United States (US) and beyond. While similar patterns have been observed with previous viral respiratory pathogens, to date, no systematic review has comprehensively documented these disparities or potential contributing factors. In response, this review aims to synthesize data on racial and ethnic disparities in morbidity and mortality due to viral acute respiratory infections (ARI) other than SARS-CoV-2. This review will focus on understanding structural health and social factors to contextualize race and ethnicity driving these disparities in the US.
We will conduct a systematic review of studies published from January 1, 2002, onward. Our search will include PubMed/MEDLINE, EBSCO Host-CINAHL Plus, PsycInfo, EMBASE, and Cochrane Library databases to identify relevant articles. We will include studies of any design that describe racial/ethnic disparities associated with viral ARI conducted in the US. Primary outcomes include incidence, disease severity or complication, hospitalization, or death attributed to ARI. Secondary outcomes include uptake of preventive interventions including vaccination, handwashing, social distancing, and wearing masks. Two reviewers will independently screen all citations, full-text articles, and abstract relevant data. Data characterizing individual-, community-, and structural-level factors associated with these disparities will be abstracted to better understand the underlying structural inequities contributing to racial disparities in ARI. We will assess the methodological quality of all studies and will conduct meta-analyses using random effects models if appropriate.
Findings from this systematic review will shed light on patterns of racial and ethnic disparities in viral ARI in the United States to support mathematical modeling of epidemic trajectories, intervention impact, and structural drivers of transmission, including structural racism. Moreover, data emerging from this review may reignite pandemic preparedness focused on communities with specific vulnerabilities related to living and working conditions given prevailing structural inequities, thus facilitating improved future pandemic responses to novel or endemic viral respiratory pathogens.
PROSPERO CRD42020219771.
由 SARS-CoV-2 引起的 COVID-19 大流行突显了美国（美国）及其他地区的种族和少数民族人群在发病率、疾病严重程度和死亡率方面存在一致的不平等现象。尽管以前的病毒性呼吸道病原体也观察到了类似的模式，但迄今为止，尚无系统综述全面记录这些差异或潜在的促成因素。有鉴于此，本综述旨在综合有关病毒性急性呼吸道感染（ARI）以外的发病率和死亡率方面的种族和族裔差异的数据。本综述将重点了解推动美国这些差异的结构性健康和社会因素，以了解种族和族裔。
我们将对 2002 年 1 月 1 日以后发表的研究进行系统综述。我们的搜索将包括 PubMed/MEDLINE、EBSCO 宿主-CINAHL Plus、PsycInfo、EMBASE 和 Cochrane 图书馆数据库，以确定相关文章。我们将纳入任何设计的研究，描述在美国进行的与病毒性 ARI 相关的种族/族裔差异。主要结局包括归因于 ARI 的发病率、疾病严重程度或并发症、住院或死亡。次要结局包括预防干预措施的采用，包括疫苗接种、洗手、保持社交距离和戴口罩。两名审查员将独立筛选所有引用、全文文章和摘要相关数据。将提取与这些差异相关的个体、社区和结构层面因素的特征数据，以更好地了解导致 ARI 中种族差异的潜在结构性不平等。我们将评估所有研究的方法学质量，如果合适，将使用随机效应模型进行荟萃分析。
本系统综述的结果将阐明美国病毒性 ARI 中种族和族裔差异的模式，以支持对传染病轨迹、干预效果以及包括结构性种族主义在内的传播结构驱动因素的数学建模。此外，从本次审查中获得的数据可能会重新引起对与生活和工作条件相关的特定脆弱性社区的大流行防范工作的关注，鉴于普遍存在的结构性不平等，这将有助于改善未来对新型或地方性病毒性呼吸道病原体的大流行应对。
PROSPERO CRD42020219771。
