退伍军人人群中的种族、合并症医疗状况和 SARS-CoV-2 检测循环阈值。
Ethnicity, Comorbid Medical Conditions, and SARS-CoV-2 Test Cycle Thresholds in the Veteran Population.
机构信息
Department of Pathology and Laboratory Medicine, Corporal Michael J Crescenz Veteran Affairs Medical Center (CMCVAMC), 3900 Woodland Ave, Philadelphia, PA, 19104, USA.
University of Pennsylvania, Philadelphia, PA, USA.
出版信息
J Racial Ethn Health Disparities. 2022 Oct;9(5):1775-1782. doi: 10.1007/s40615-021-01114-4. Epub 2021 Jul 28.
BACKGROUND AND AIMS
It has been documented that African Americans have been significantly affected by COVID-19 infection due to systemic societal factors, which may lead to increases in comorbid medical history and subsequently vulnerability to having higher viral loads as measured by the cycle threshold/number (CT/CN) values by reverse transcriptase polymerase chain reaction (RT-PCR). Differences in CT/CN values by ethnicity and comorbid medical history could play an important role in public health research, particularly in elucidating the reasons for differential public health outcomes by ethnicity, as viral loads are known to correlate with disease severity. However, there is a gap in the literature regarding CT/CN values by ethnicity and comorbid medical history. Therefore, this study seeks to address this literature gap and its important implication for public health research.
METHODS
A retrospective review of all SARS-CoV-2 RT-PCR tests collected at the regional Veterans Administration Medical Center (VAMC) serving the Philadelphia area from March 17, 2020, to May 20, 2020, was performed to collect demographic information such as race, gender, and age. In addition, comorbid medical conditions, clinical course, and CT/CN values were obtained for the positive cases.
RESULTS
There was a total of 1524 patients tested for SARS-CoV-2. A total of 713/1524 patients (46.8%) were African American. A total of 187/1524 patients (12%) had tested positive for SARS-CoV-2 from which 139/187 (74%) were African American. African American patients required more intensive unit care. Both African Americans and other ethnicities had similar rates of comorbid medical conditions. On comparison of the ethnic groups, there were lower viral loads in African Americans on admission, though the difference was not statistically significant.
CONCLUSION
African American Veterans tested positive at higher rates and require more ICU care, despite similar rates of comorbid illness and viral loads.
背景与目的
有文献记录表明，由于系统性社会因素，非裔美国人受到 COVID-19 感染的影响显著，这可能导致合并症病史增加，继而病毒载量更高，这可以通过逆转录聚合酶链反应（RT-PCR）的循环阈值/数量（CT/CN）值来衡量。不同种族和合并症病史的 CT/CN 值差异可能在公共卫生研究中发挥重要作用，特别是在阐明因种族而导致的不同公共卫生结果的原因方面，因为病毒载量与疾病严重程度相关。然而，关于种族和合并症病史的 CT/CN 值的文献存在空白。因此，本研究旨在填补这一文献空白及其对公共卫生研究的重要意义。
方法
对 2020 年 3 月 17 日至 5 月 20 日在为费城地区服务的地区退伍军人管理局医疗中心（VAMC）收集的所有 SARS-CoV-2 RT-PCR 检测进行回顾性审查，以收集种族、性别和年龄等人口统计学信息。此外，还获得了阳性病例的合并症病史、临床过程和 CT/CN 值。
结果
共检测了 1524 例 SARS-CoV-2 患者。共有 713/1524 例（46.8%）为非裔美国人。共有 187/1524 例（12%）的 SARS-CoV-2 检测呈阳性，其中 139/187（74%）为非裔美国人。非裔美国患者需要更多的重症监护病房护理。非裔美国人和其他族裔的合并症发病率相似。在比较族裔时，非裔美国人入院时的病毒载量较低，但差异无统计学意义。
结论
尽管合并症发病率和病毒载量相似，但接受检测的非裔美国退伍军人阳性率更高，需要更多的 ICU 护理。
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