西班牙新冠肺炎住院患者的种族与临床结局：多中心SEMI-COVID-19注册研究结果
Ethnicity and Clinical Outcomes in Patients Hospitalized for COVID-19 in Spain: Results from the Multicenter SEMI-COVID-19 Registry.
作者信息
Ramos-Rincon Jose-Manuel, Cobos-Palacios Lidia, López-Sampalo Almudena, Ricci Michele, Rubio-Rivas Manuel, Martos-Pérez Francisco, Lalueza-Blanco Antonio, Moragón-Ledesma Sergio, Fonseca-Aizpuru Eva-María, García-García Gema-María, Beato-Perez Jose-Luis, Josa-Laorden Claudia, Arnalich-Fernández Francisco, Molinos-Castro Sonia, Torres-Peña José-David, Artero Arturo, Vargas-Núñez Juan-Antonio, Mendez-Bailon Manuel, Loureiro-Amigo Jose, Hernández-Garrido María-Soledad, Peris-García Jorge, López-Reboiro Manuel-Lorenzo, Barón-Franco Bosco, Casas-Rojo Jose-Manuel, Gómez-Huelgas Ricardo
机构信息
Clinical Medicine Department, Miguel Hernandez University of Elche, 03550 Alicante, Spain.
Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), 29010 Malaga, Spain.
出版信息
J Clin Med. 2022 Mar 31;11(7):1949. doi: 10.3390/jcm11071949.
(1) Background: This work aims to analyze clinical outcomes according to ethnic groups in patients hospitalized for COVID-19 in Spain. (2) Methods: This nationwide, retrospective, multicenter, observational study analyzed hospitalized patients with confirmed COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry) from 1 March 2020 to 31 December 2021. Clinical outcomes were assessed according to ethnicity (Latin Americans, Sub-Saharan Africans, Asians, North Africans, Europeans). The outcomes were in-hospital mortality (IHM), intensive care unit (ICU) admission, and the use of invasive mechanical ventilation (IMV). Associations between ethnic groups and clinical outcomes adjusted for patient characteristics and baseline Charlson Comorbidity Index values and wave were evaluated using logistic regression. (3) Results: Of 23,953 patients (median age 69.5 years, 42.9% women), 7.0% were Latin American, 1.2% were North African, 0.5% were Asian, 0.5% were Sub-Saharan African, and 89.7% were European. Ethnic minority patients were significantly younger than European patients (median (IQR) age 49.1 (40.5−58.9) to 57.1 (44.1−67.1) vs. 71.5 (59.5−81.4) years, p < 0.001). The unadjusted IHM was higher in European (21.6%) versus North African (11.4%), Asian (10.9%), Latin American (7.1%), and Sub-Saharan African (3.2%) patients. After further adjustment, the IHM was lower in Sub-Saharan African (OR 0.28 (0.10−0.79), p = 0.017) versus European patients, while ICU admission rates were higher in Latin American and North African versus European patients (OR (95%CI) 1.37 (1.17−1.60), p < 0.001) and (OR (95%CI) 1.74 (1.26−2.41), p < 0.001). Moreover, Latin American patients were 39% more likely than European patients to use IMV (OR (95%CI) 1.43 (1.21−1.71), p < 0.001). (4) Conclusion: The adjusted IHM was similar in all groups except for Sub-Saharan Africans, who had lower IHM. Latin American patients were admitted to the ICU and required IMV more often.
（1）背景：本研究旨在分析西班牙因新冠肺炎住院患者按种族划分的临床结局。（2）方法：这项全国性、回顾性、多中心观察性研究分析了2020年3月1日至2021年12月31日期间西班牙150家医院（SEMI-COVID-19登记处）确诊的新冠肺炎住院患者。根据种族（拉丁美洲人、撒哈拉以南非洲人、亚洲人、北非人、欧洲人）评估临床结局。结局指标包括住院死亡率（IHM）、重症监护病房（ICU）入住率和有创机械通气（IMV）的使用情况。使用逻辑回归评估种族与临床结局之间的关联，并对患者特征、基线查尔森合并症指数值和疫情波次进行了调整。（3）结果：在23953名患者中（中位年龄69.5岁，42.9%为女性），7.0%为拉丁美洲人，1.2%为北非人，0.5%为亚洲人，0.5%为撒哈拉以南非洲人，89.7%为欧洲人。少数族裔患者明显比欧洲患者年轻（中位（IQR）年龄49.1（40.5−58.9）岁至57.1（44.1−67.1）岁，而欧洲患者为71.5（59.5−81.4）岁，p<0.001）。未经调整的住院死亡率在欧洲患者中（21.6%）高于北非人（11.4%）、亚洲人（10.9%）、拉丁美洲人（7.1%）和撒哈拉以南非洲人（3.2%）。进一步调整后，撒哈拉以南非洲患者的住院死亡率低于欧洲患者（OR 0.28（0.10−0.79），p = 0.017），而拉丁美洲和北非患者的ICU入住率高于欧洲患者（OR（95%CI）1.37（1.17−1.60），p<0.001）和（OR（95%CI）1.74（1.26−2.41），p<0.001）。此外，拉丁美洲患者使用IMV的可能性比欧洲患者高39%（OR（95%CI）1.43（1.21−1.71），p<0.001）。（4）结论：除撒哈拉以南非洲人住院死亡率较低外，所有组调整后的住院死亡率相似。拉丁美洲患者更常入住ICU且需要使用IMV。
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