在英国，LGBT+人群在新冠疫情下的生活：对英国关于新冠疫情对性少数和性别少数人群影响的研究进行系统评价。
Life under COVID-19 for LGBT+ people in the UK: systematic review of UK research on the impact of COVID-19 on sexual and gender minority populations.
机构信息
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Lancashire Applied Health Research Collaboration Hub (LARCH), University of Central Lancashire, Preston, UK.
出版信息
BMJ Open. 2021 Jul 30;11(7):e050092. doi: 10.1136/bmjopen-2021-050092.
OBJECTIVE
To systematically review all published and unpublished evidence on the impact of the COVID-19 pandemic on the health and well-being of UK sexual and gender minority (LGBT+; lesbian, gay, bisexual, transgender, non-binary, intersex and queer) people.
METHODS
Any relevant studies with or without comparator were included, with outcomes of: COVID-19 incidence, hospitalisation rates, illness severity, death rates, other health and well-being. Six databases (platforms) were searched-CINAHL Plus (Ovid), Cochrane Central (Cochrane Library), Medline (Ovid), Embase (Ovid), Science Citation Index (Web of Science) and Scopus between 2019 and 2020 in December 2020, using synonyms for sexual and gender minorities and COVID-19 search terms. Data extraction and quality assessment (using the relevant Joanna Briggs checklist) were in duplicate with differences resolved through discussion. Results were tabulated and synthesis was through narrative description.
RESULTS
No published research was found on any outcomes. Eleven grey literature reports found to be of low quality were included, mostly conducted by small LGBT+ charities. Only four had heterosexual/cisgender comparators. Mental health and well-being, health behaviours, safety, social connectedness and access to routine healthcare all showed poorer or worse outcomes than comparators.
CONCLUSIONS
Lack of research gives significant concern, given pre-existing health inequities. Social and structural factors may have contributed to poorer outcomes (mental health, well-being and access to healthcare). Paucity of evidence is driven by lack of routinely collected sexual orientation and gender identity data, possibly resulting from institutional homophobia/transphobia which needs to be addressed. Men are more at risk of serious illness from COVID-19 than women, so using data from trans women and men might have started to answer questions around whether higher rates were due to sex hormone or chromosomal effects. Routine data collection on sexual orientation and gender identity is required to examine the extent to which COVID-19 is widening pre-existing health inequalities.
PROSPERO REGISTRATION NUMBER
CRD42020224304.
目的
系统回顾所有已发表和未发表的关于 COVID-19 大流行对英国性少数群体（LGBT+；女同性恋、男同性恋、双性恋、跨性别、非二进制、间性和酷儿）人群健康和福祉影响的证据。
方法
纳入了有或没有对照组的所有相关研究，其结果为：COVID-19 发病率、住院率、疾病严重程度、死亡率、其他健康和福祉。2019 年至 2020 年 12 月，在 6 个数据库（平台）中（CINAHL Plus（Ovid）、Cochrane Central（Cochrane Library）、Medline（Ovid）、Embase（Ovid）、Science Citation Index（Web of Science）和 Scopus），使用性少数群体和 COVID-19 搜索词的同义词进行了搜索。数据提取和质量评估（使用相关的 Joanna Briggs 清单）是双人进行的，如果存在分歧，则通过讨论解决。结果以表格形式列出，并通过叙述性描述进行综合。
结果
未发现任何研究报告有关于任何结果。纳入了 11 份低质量的灰色文献报告，这些报告大多由小型 LGBT+慈善机构进行。只有四份研究有异性恋/顺性别对照组。心理健康和福祉、健康行为、安全性、社会联系和常规医疗保健的获得都显示出比对照组更差或更差的结果。
结论
由于先前存在的健康不平等，缺乏研究令人严重关切。社会和结构性因素可能导致了更差的结果（心理健康、福祉和获得医疗保健）。证据不足是由于缺乏常规收集的性取向和性别认同数据所致，这可能是由于机构内的恐同/恐跨性别问题所致，需要加以解决。男性比女性更容易患 COVID-19 重症，因此使用跨性别女性和男性的数据可能已经开始回答更高的发病率是否归因于性激素或染色体效应的问题。需要常规收集性取向和性别认同数据，以检查 COVID-19 是否扩大了先前存在的健康不平等。
PROSPERO 注册号：CRD42020224304。
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