Department of Internal Medicine, Saint Louis University, 1100 South Grand Blvd, Doisy Research Center, 8th floor, Saint Louis, MO 63104 USA.
Department of Internal Medicine, Saint Louis University, 1100 South Grand Blvd, Doisy Research Center, 8th floor, Saint Louis, MO 63104 USA.
J Natl Med Assoc. 2022 Feb;114(1):56-68. doi: 10.1016/j.jnma.2021.12.002. Epub 2022 Jan 7.
Recent reports indicate that African Americans have higher mortality rates from SARS-CoV-2 coronavirus disease 19 (COVID-19) compared to Caucasians, with more marked differences in the Midwest region of the US. This study was performed to study differences in COVID-19 related mortality and hospital length of stay (LOS) between African Americans and Caucasians in Midwest setting, and identify factors associated with mortality and LOS.
Data were collected from the electronic health records (EHR) of patients admitted to hospitals in Midwest region of the US. EHR of 471 COVID-19 patients were reviewed.
Approximately 63% were African Americans and 34% Caucasians. One hundred sixteen variables were tested. There was no significant difference in hospital mortality between African Americans and Caucasians (OR 1, 95% CI 0.48-1.94). Older age, Chronic kidney disease, mental status change, mechanical ventilation, vasopressor support, high neutrophil count, elevated AST and ALT, high lung involvement severity score and elevated CRP were associated with mortality in a univariate analysis (P < 0.05). Multivariable modeling indicated that mechanical ventilation was the only factor that predicted mortality (OR 6, 95% CI: 2.94-12.48). The LOS did not differ in African Americans and Caucasians. The use of oxygen via high flow nasal cannula (Survival Estimate 1.6, 95% CI: 1.20-2.26), low estimated glomerular filtration rate (Survival Estimate 1.4, 95% CI: 1.05-1.82) and mechanical ventilation (Survival Estimate 3.5, 95% CI: 2.72-4.37) were predictors of LOS.
This study performed in Midwest setting in the US showed that race did not affect in-hospital mortality and LOS. Our analysis demonstrated new predictors of LOS.
最近的报告表明，非裔美国人感染 SARS-CoV-2 冠状病毒病 19（COVID-19）的死亡率高于白种人，在美国中西部地区的差异更为明显。本研究旨在研究中西部地区非裔美国人和白种人 COVID-19 相关死亡率和住院时间（LOS）的差异，并确定与死亡率和 LOS 相关的因素。
数据来自美国中西部地区医院电子健康记录（EHR）。回顾了 471 例 COVID-19 患者的 EHR。
大约 63%是非裔美国人，34%是白种人。测试了 116 个变量。非裔美国人和白种人之间的住院死亡率没有显著差异（OR 1，95%CI 0.48-1.94）。年龄较大、慢性肾脏病、精神状态改变、机械通气、血管加压素支持、中性粒细胞计数升高、AST 和 ALT 升高、肺受累严重程度评分升高和 CRP 升高在单变量分析中与死亡率相关（P<0.05）。多变量模型表明，机械通气是唯一预测死亡率的因素（OR 6，95%CI：2.94-12.48）。非裔美国人和白种人之间的 LOS 没有差异。高流量鼻导管吸氧（生存估计值 1.6，95%CI：1.20-2.26）、低估计肾小球滤过率（生存估计值 1.4，95%CI：1.05-1.82）和机械通气（生存估计值 3.5，95%CI：2.72-4.37）的使用是 LOS 的预测因素。
本研究在美国中西部地区进行，结果表明种族并不影响住院死亡率和 LOS。我们的分析表明了 LOS 的新预测因素。
