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利用回顾性队列研究,探讨种族/民族和社会经济地位与费城医疗中心 COVID-19 30 天死亡率的关系。

Association of race/ethnicity and socioeconomic status with COVID-19 30-day mortality at a Philadelphia medical center using a retrospective cohort study.

机构信息

Department of Medicine, Division of Hospital Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

出版信息

J Med Virol. 2022 Mar;94(3):906-917. doi: 10.1002/jmv.27365. Epub 2021 Oct 11.

DOI:10.1002/jmv.27365
PMID:34585772
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8662195/
Abstract

COVID-19 has disproportionately affected low-income communities and people of color. Previous studies demonstrated that race/ethnicity and socioeconomic status (SES) are not independently correlated with COVID-19 mortality. The purpose of our study is to determine the effect of race/ethnicity and SES on COVID-19 30-day mortality in a diverse, Philadelphian population. This is a retrospective cohort study in a single-center tertiary care hospital in Philadelphia, PA. The study includes adult patients hospitalized with polymerase-chain-reaction-confirmed COVID-19 between March 1, 2020 and June 6, 2020. The primary outcome was a composite of COVID-19 death or hospice discharge within 30 days of discharge. The secondary outcome was intensive care unit (ICU) admission. The study included 426 patients: 16.7% died, 3.3% were discharged to hospice, and 20.0% were admitted to the ICU. Using multivariable analysis, race/ethnicity was not associated with the primary nor secondary outcome. In Model 4, age greater than 75 (odds ratio [OR]: 11.01; 95% confidence interval [CI]: 1.96-61.97) and renal disease (OR: 2.78; 95% CI: 1.31-5.90) were associated with higher odds of the composite primary outcome. Living in a "very-low-income area" (OR: 0.29; 95% CI: 0.12-0.71) and body mass index (BMI) 30-35 (OR: 0.24; 95% CI: 0.08-0.69) were associated with lower odds of the primary outcome. When controlling for demographics, SES, and comorbidities, race/ethnicity was not independently associated with the composite primary outcome. Very-low SES, as extrapolated from census-tract-level income data, was associated with lower odds of the composite primary outcome.

摘要

COVID-19 对低收入社区和有色人种的影响不成比例。先前的研究表明,种族/民族和社会经济地位(SES)与 COVID-19 死亡率没有独立相关性。我们研究的目的是确定种族/民族和 SES 对费城多元化人群中 COVID-19 30 天死亡率的影响。这是一项在宾夕法尼亚州费城的一家单中心三级保健医院进行的回顾性队列研究。研究包括 2020 年 3 月 1 日至 6 月 6 日期间因聚合酶链反应确诊 COVID-19 住院的成年患者。主要结局是出院后 30 天内 COVID-19 死亡或临终关怀出院的复合结局。次要结局是入住重症监护病房(ICU)。该研究共纳入 426 例患者:16.7%死亡,3.3%出院至临终关怀,20.0%入住 ICU。多变量分析显示,种族/民族与主要或次要结局均无关。在模型 4 中,年龄大于 75 岁(比值比 [OR]:11.01;95%置信区间 [CI]:1.96-61.97)和肾脏疾病(OR:2.78;95% CI:1.31-5.90)与复合主要结局的更高可能性相关。居住在“非常低收入地区”(OR:0.29;95% CI:0.12-0.71)和 BMI 30-35(OR:0.24;95% CI:0.08-0.69)与主要结局的可能性较低相关。在控制人口统计学、SES 和合并症后,种族/民族与复合主要结局没有独立相关性。从人口普查区收入数据推断出的非常低的 SES 与复合主要结局的可能性较低相关。

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