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一项系统回顾和荟萃分析,探讨了在因 2019 年冠状病毒病住院的患者中,深静脉血栓形成和肺栓塞事件的种族差异。

A systematic review and meta-analysis of racial disparities in deep vein thrombosis and pulmonary embolism events in patients hospitalized with coronavirus disease 2019.

机构信息

Department of Critical Care, Mayo Clinic, Jacksonville, FL.

Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, FL.

出版信息

J Vasc Surg Venous Lymphat Disord. 2022 Jul;10(4):939-944.e3. doi: 10.1016/j.jvsv.2022.03.003. Epub 2022 Mar 17.

Abstract

OBJECTIVE

Coronavirus disease 2019 (COVID-19) is associated with an increased risk of venous thromboembolism (VTE). Recent studies have characterized racial disparities in the incidence of VTE. The aim of our study was to present a systematic review and meta-analysis to assess the association between race and VTE in patients hospitalized with COVID-19.

METHODS

We performed a systematic literature review to evaluate the number of deep vein thrombosis (DVT) and pulmonary embolism (PE) events reported by racial groups in patients hospitalized with COVID-19. For the qualitative analysis, independent reviewers extracted the data from eligible studies, and we used the Newcastle-Ottawa scale to assess the quality of design and content for accurate interpretation. For the quantitative analysis, we pooled the odds ratios with Der Simonian and Laird random effects models.

RESULTS

The qualitative analysis included 11 studies, with 6 included in the meta-analysis. All studies were observational, retrospective cohort studies, except for one retrospective case-control study. Six studies were eligible for the meta-analysis owing to the high interstudy heterogeneity; thus, the variable reports of racial groups reduced the cohort to Black/African American and White patients (n = 9723) in the analysis. The estimated proportion for DVT and PE events for Black/African American and White patients was 0.07 (95% confidence interval, 0.00-0.10) and 0.04 (95% confidence interval, 0.00-0.07), respectively. The P value of .13 suggested nonsignificant differences in the VTE rates between Black/African American and White patients.

CONCLUSIONS

In our study, the proportion of DVT and PE events between Black/African American and White patients with COVID-19 were comparable. Future COVID-19 studies should include systematic racial group reporting to identify any disparities in the setting of VTE events.

摘要

目的

新型冠状病毒病 2019(COVID-19)与静脉血栓栓塞症(VTE)的风险增加有关。最近的研究表明,VTE 的发生率存在种族差异。本研究旨在进行系统综述和荟萃分析,以评估 COVID-19 住院患者种族与 VTE 之间的关系。

方法

我们进行了系统的文献综述,以评估 COVID-19 住院患者中按种族报告的深静脉血栓形成(DVT)和肺栓塞(PE)事件的数量。对于定性分析,独立评审员从合格研究中提取数据,我们使用纽卡斯尔-渥太华量表评估设计和内容的质量,以进行准确的解释。对于定量分析,我们使用德西蒙尼和莱尔德随机效应模型来汇总优势比。

结果

定性分析包括 11 项研究,其中 6 项纳入荟萃分析。所有研究均为观察性、回顾性队列研究,除了一项回顾性病例对照研究。由于研究间异质性较高,有 6 项研究符合荟萃分析的条件;因此,由于种族报告的变量,分析中减少了队列的数量,仅包括黑种人和白种人(n=9723)。黑种人和白种人 DVT 和 PE 事件的估计比例分别为 0.07(95%置信区间,0.00-0.10)和 0.04(95%置信区间,0.00-0.07)。P 值为.13 表明黑种人和白种人 VTE 发生率无显著差异。

结论

在我们的研究中,COVID-19 黑种人和白种人患者 DVT 和 PE 事件的比例相当。未来的 COVID-19 研究应包括系统的种族群体报告,以确定 VTE 事件发生时的任何差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f54/8928725/e6372aaa0866/gr1_lrg.jpg

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