Jun Tomi, Mathew Divij, Sharma Navya, Nirenberg Sharon, Huang Hsin-Hui, Kovatch Patricia, Wherry E John, Huang Kuan-Lin
Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Res Sq. 2022 Mar 22:rs.3.rs-1055587. doi: 10.21203/rs.3.rs-1055587/v1.
Disparate COVID-19 outcomes have been observed between Hispanic, Non-Hispanic Black, and White patients. The underlying causes for these disparities are not fully understood. This was a retrospective study utilizing electronic medical record data from five hospitals within a single academic health system based in New York City. Multivariable logistic regression models were used to identify demographic, clinical, and lab values associated with in-hospital mortality. 3,086 adult patients with self-reported race/ethnicity information presenting to the emergency department and hospitalized with COVID-19 up to April 13, 2020 were included in this study. While older age (multivariable OR 1.06, 95% CI 1.05-1.07) and baseline hypoxia (multivariable OR 2.71, 95% CI 2.17-3.36) were associated with increased mortality overall and across all races/ethnicities, Non-Hispanic Black (median age 67, IQR 58-76) and Hispanic (median age 63, IQR 50-74) patients were younger and had different comorbidity profiles compared to Non-Hispanic White patients (median age 73, IQR 62-84; p<0.05 for both comparisons). Among inflammatory markers associated with COVID-19 mortality, there was a significant interaction between the Non-Hispanic Black population and interleukin-1-beta (interaction p-value 0.04). This analysis of a multi-ethnic cohort highlights the need for inclusion and consideration of diverse popualtions in ongoing COVID-19 trials targeting inflammatory cytokines.
在西班牙裔、非西班牙裔黑人及白人患者中观察到了不同的新冠病毒疾病(COVID-19)结局。这些差异的根本原因尚未完全明确。这是一项回顾性研究,利用了纽约市一个学术医疗系统内五家医院的电子病历数据。采用多变量逻辑回归模型来确定与院内死亡率相关的人口统计学、临床和实验室指标。本研究纳入了截至2020年4月13日因COVID-19就诊于急诊科并住院的3086名有自我报告种族/族裔信息的成年患者。虽然高龄(多变量比值比1.06,95%置信区间1.05 - 1.07)和基线低氧血症(多变量比值比2.71,95%置信区间2.17 - 3.36)与所有种族/族裔的总体死亡率增加相关,但与非西班牙裔白人患者(年龄中位数73岁,四分位间距62 - 84岁)相比,非西班牙裔黑人患者(年龄中位数67岁,四分位间距58 - 76岁)和西班牙裔患者(年龄中位数63岁,四分位间距50 - 74岁)更年轻,且合并症情况不同(两项比较p均<0.05)。在与COVID-19死亡率相关的炎症标志物中,非西班牙裔黑人人群与白细胞介素-1-β之间存在显著交互作用(交互p值0.04)。对一个多民族队列的这项分析凸显了在针对炎症细胞因子的正在进行的COVID-19试验中纳入和考虑不同人群的必要性。