Office of Health Equity and Inclusion (OHEI), Nemours Children's Healthcare System, Wilmington, DE, USA.
Biological Sciences Departmenmt, University of Delaware, DE, Newark, USA.
J Racial Ethn Health Disparities. 2023 Jun;10(3):1187-1193. doi: 10.1007/s40615-022-01305-7. Epub 2022 May 23.
The COVID-19 morbidity with SARS-CoV-2 as a causative pathogenic microbe remains a pandemic with children experiencing less mortality but with severe manifestations. The current study aimed to assess SARS-CoV-2 cumulative incidence, COVID-19 hospitalization, and ICU admission with respect to racial differentials.
A cross-sectional nonexperimental epidemiologic design was used to examine pediatric COVID-19 data from CDC during 2020. The variables assessed were ICU admissions, hospitalization, sex, race, and region. The Chi-Square (X) statistic was used to examine the independence of the variables by race, while the binomial regression model was used to predict racial risk differentials in hospitalization and ICU admissions.
The pediatric COVID-19 data observed the cumulative incidence of hospitalization to be 96,376, while ICU admission was 12,448. Racial differences were observed in hospitalization, ICU admissions, sex, and region. With respect to COVID-19 hospitalization, Black/African American (AA) children were two times as likely to be hospitalized compared to their White counterparts, prevalence risk ratio (pRR) = 2.20, 99% confidence interval (CI = 2.12-2.28). Similarly, Asians were 45% more likely to be hospitalized relative to their White counterparts, pRR = 1.45, 99% CI = 1.32-1.60. Regarding ICU admission, there was a disproportionate racial burden, implying excess ICU admission among Black/AA children relative to their White counterparts, pRR = 5.18, 99% CI = 4.44-6.04. Likewise, Asian children were 3 times as likely to be admitted to the ICU compared to their White counterparts, pRR = 3.36, 99% CI = 2.37-4.77. Additionally, American Indians/Alaska Natives were 2 times as likely to be admitted to ICU, pRR = 2.54, 99% CI = 0.82-7.85.
Racial disparities were observed in COVID-19 hospitalization and ICU admission among the US children, with Black/AA children being disproportionately affected, implying health equity transformation.
以 SARS-CoV-2 为致病微生物的 COVID-19 发病率仍然是一种大流行，儿童死亡率较低，但临床表现严重。本研究旨在评估 SARS-CoV-2 的累积发病率、COVID-19 住院和 ICU 入院情况，以及种族差异。
本研究采用横断面非实验性流行病学设计，检查了 2020 年期间 CDC 的儿科 COVID-19 数据。评估的变量包括 ICU 入院、住院、性别、种族和地区。卡方（X）统计用于检验种族变量的独立性，而二项式回归模型用于预测住院和 ICU 入院的种族风险差异。
儿科 COVID-19 数据观察到住院的累积发病率为 96376 例，而 ICU 入院为 12448 例。在住院、ICU 入院、性别和地区方面观察到种族差异。关于 COVID-19 住院治疗，与白人相比，黑人/非裔美国人（AA）儿童住院的可能性是其两倍，流行风险比（pRR）=2.20，99%置信区间（CI）=2.12-2.28。同样，亚洲人住院的可能性比白人高 45%，pRR=1.45，99%CI=1.32-1.60。关于 ICU 入院，存在不成比例的种族负担，这意味着黑人/AA 儿童的 ICU 入院率相对较高，与白人相比，pRR=5.18，99%CI=4.44-6.04。同样，亚洲儿童入住 ICU 的可能性是白人的三倍，pRR=3.36，99%CI=2.37-4.77。此外，美国印第安人/阿拉斯加原住民入住 ICU 的可能性是白人的两倍，pRR=2.54，99%CI=0.82-7.85。
在美国儿童中，COVID-19 住院和 ICU 入院存在种族差异，黑人/AA 儿童受到不成比例的影响，这意味着需要进行医疗公平转型。
