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在伦敦东部 COVID-19 感染第二波期间住院和医院结果的民族差异。

Ethnic disparities in hospitalisation and hospital-outcomes during the second wave of COVID-19 infection in east London.

机构信息

William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK.

Adult Critical Care Unit, Royal London Hospital, Barts Health NHS Trust, London, E1 1FR, UK.

出版信息

Sci Rep. 2022 Mar 8;12(1):3721. doi: 10.1038/s41598-022-07532-6.

Abstract

It is unclear if changes in public behaviours, developments in COVID-19 treatments, improved patient care, and directed policy initiatives have altered outcomes for minority ethnic groups in the second pandemic wave. This was a prospective analysis of patients aged ≥ 16 years having an emergency admission with SARS-CoV-2 infection between 01/09/2020 and 17/02/2021 to acute NHS hospitals in east London. Multivariable survival analysis was used to assess associations between ethnicity and mortality accounting for predefined risk factors. Age-standardised rates of hospital admission relative to the local population were compared between ethnic groups. Of 5533 patients, the ethnic distribution was White (n = 1805, 32.6%), Asian/Asian British (n = 1983, 35.8%), Black/Black British (n = 634, 11.4%), Mixed/Other (n = 433, 7.8%), and unknown (n = 678, 12.2%). Excluding 678 patients with missing data, 4855 were included in multivariable analysis. Relative to the White population, Asian and Black populations experienced 4.1 times (3.77-4.39) and 2.1 times (1.88-2.33) higher rates of age-standardised hospital admission. After adjustment for various patient risk factors including age, sex, and socioeconomic deprivation, Asian patients were at significantly higher risk of death within 30 days (HR 1.47 [1.24-1.73]). No association with increased risk of death in hospitalised patients was observed for Black or Mixed/Other ethnicity. Asian and Black ethnic groups continue to experience poor outcomes following COVID-19. Despite higher-than-expected rates of hospital admission, Black and Asian patients also experienced similar or greater risk of death in hospital since the start of the pandemic, implying a higher overall risk of COVID-19 associated death in these communities.

摘要

目前尚不清楚公众行为的变化、COVID-19 治疗方法的发展、患者护理水平的提高以及有针对性的政策举措是否改变了第二波疫情中少数民族群体的预后。这是对 2020 年 9 月 1 日至 2021 年 2 月 17 日期间在伦敦东部的 NHS 医院因 SARS-CoV-2 感染而紧急入院的年龄≥16 岁患者的前瞻性分析。使用多变量生存分析评估了种族与死亡率之间的关联,同时考虑了预先定义的危险因素。比较了不同种族群体之间与当地人群相比的住院率的年龄标准化率。在 5533 名患者中,种族分布为白人(n=1805,32.6%)、亚洲/亚裔英国人(n=1983,35.8%)、黑人/非裔英国人(n=634,11.4%)、混血/其他(n=433,7.8%)和未知(n=678,12.2%)。排除 678 名数据缺失的患者后,4855 名患者纳入多变量分析。与白人人口相比,亚洲人和黑人人口的年龄标准化住院率分别高出 4.1 倍(3.77-4.39)和 2.1 倍(1.88-2.33)。在校正了年龄、性别和社会经济剥夺等各种患者风险因素后,亚洲患者在 30 天内死亡的风险显著更高(HR 1.47[1.24-1.73])。黑人或混血/其他种族与住院患者死亡风险增加无关。在 COVID-19 之后,亚洲和黑人族群继续面临不良预后。尽管住院率高于预期,但自大流行开始以来,黑人患者和亚洲患者在医院的死亡风险也相似或更高,这意味着这些社区中 COVID-19 相关死亡的总体风险更高。

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