Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1133, New York, NY, 10029, USA.
Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1023, New York, NY, 10029, USA.
BMC Public Health. 2021 Jul 24;21(1):1452. doi: 10.1186/s12889-021-11498-x.
New York City (NYC) was the epicenter of the COVID-19 pandemic, and is home to underserved populations with higher prevalence of chronic conditions that put them in danger of more serious infection. Little is known about how the presence of chronic risk factors correlates with mortality at the population level. Here we determine the relationship between these factors and COVD-19 mortality in NYC.
A cross-sectional study of mortality data obtained from the NYC Coronavirus data repository (03/02/2020-07/06/2020) and the prevalence of neighborhood-level risk factors for COVID-19 severity was performed. A risk index was created based on the CDC criteria for risk of severe illness and complications from COVID-19, and stepwise linear regression was implemented to predict the COVID-19 mortality rate across NYC zip code tabulation areas (ZCTAs) utilizing the risk index, median age, socioeconomic status index, and the racial and Hispanic composition at the ZCTA-level as predictors.
The COVID-19 death rate per 100,000 persons significantly decreased with the increasing proportion of white residents (β = - 0.91, SE = 0.31, p = 0.0037), while the increasing proportion of Hispanic residents (β = 0.90, SE = 0.38, p = 0.0200), median age (β = 3.45, SE = 1.74, p = 0.0489), and COVID-19 severity risk index (β = 5.84, SE = 0.82, p < 0.001) were statistically significantly positively associated with death rates.
Disparities in COVID-19 mortality exist across NYC and these vulnerable areas require increased attention, including repeated and widespread testing, to minimize the threat of serious illness and mortality.
纽约市（NYC）是 COVID-19 大流行的震中，是服务不足的人群的所在地，这些人群患有更高比例的慢性疾病，使他们面临更严重感染的危险。人们对慢性危险因素的存在与人群水平的死亡率之间的相关性知之甚少。在这里，我们确定了这些因素与纽约市 COVID-19 死亡率之间的关系。
对从纽约市冠状病毒数据存储库（2020 年 3 月 2 日至 2020 年 7 月 6 日）获得的死亡率数据和社区一级 COVID-19 严重程度的风险因素进行了横断面研究。根据疾病预防控制中心（CDC）关于 COVID-19 严重疾病和并发症风险的标准，创建了一个风险指数，并利用风险指数、中位数年龄、社会经济地位指数以及 ZCTA 级别的种族和西班牙裔构成，对整个纽约市邮政编码区域（ZCTA）的 COVID-19 死亡率进行了逐步线性回归预测。
每 100000 人中 COVID-19 死亡率与白人居民比例的增加显著降低（β=-0.91，SE=0.31，p=0.0037），而西班牙裔居民比例的增加（β=0.90，SE=0.38，p=0.0200）、中位数年龄（β=3.45，SE=1.74，p=0.0489）和 COVID-19 严重程度风险指数（β=5.84，SE=0.82，p<0.001）与死亡率呈统计学显著正相关。
纽约市的 COVID-19 死亡率存在差异，这些脆弱地区需要更多关注，包括反复和广泛的检测，以最大程度地降低严重疾病和死亡的威胁。
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