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《西班牙裔人群中的 COVID-19 大流行:初级保健视角》。

The COVID-19 Pandemic in a Hispanic Population: A Primary Care Perspective.

机构信息

From Alivio Medical Center, Indianapolis, IN (CDO, GMP, JCS, JA, LHP, CL, YELM, ALY); Case Western Reserve University, Cleveland, OH (CL).

出版信息

J Am Board Fam Med. 2022 Jul-Aug;35(4):686-694. doi: 10.3122/jabfm.2022.04.210163.

Abstract

INTRODUCTION

The COVID-19 global pandemic has affected all ethnic and minority groups although not equally. The goals of the present study are twofold: describe the diverse COVID-19-related care needs Hispanic patients presenting to a primary care facility and the symptom clusters and socioeconomic factors that may impact their wellbeing.

METHODS

This is a retrospective cohort of Hispanic patients in an outpatient clinic serving an urban lower socioeconomic demographic, between May 9 and July 31, 2020. COVID-19 infection was confirmed by polymerase chain reaction or rapid antibody test. Student's t-test was used for means and the chi was used for comparisons of proportions.

RESULTS

A total of 6616 patients visited Alivio, 409 were triaged to a containment area, and 378 were tested for COVID-19; 230 with, 148 without symptoms. Of those tested, 161(42.6%) were positive, representing 2.4% of total patients seen. Age, temperature, and pulse rate were all significantly higher in patients with symptoms compared with those without. Symptoms were grouped into 5 clusters: constitutional, n = 143(62%), respiratory, n = 136 (59%), and somatic, n = 97(42%) were most common. No single cluster was particularly diagnostic of COVID-19, although those with symptoms in multiple clusters were more likely to test positive, < .001. The majority worked in essential jobs, were uninsured, and had more than half had prolonged symptoms.

CONCLUSIONS

Hispanic patients have diverse reasons for seeking health care and for testing in a pandemic. COVID-19 is a syndromic disease as evidenced from the clustering of symptoms. Essential workers and uninsured health status may lead to more prolonged disease course.

摘要

简介

COVID-19 全球大流行影响了所有族裔和少数群体,尽管影响程度不同。本研究的目的有两个:描述在一家初级保健机构就诊的西班牙裔患者的 COVID-19 相关护理需求的多样性,以及可能影响他们健康的症状群和社会经济因素。

方法

这是一项回顾性队列研究,纳入了 2020 年 5 月 9 日至 7 月 31 日期间在一家为城市低收入人群服务的门诊诊所就诊的西班牙裔患者。COVID-19 感染通过聚合酶链反应或快速抗体检测确诊。采用学生 t 检验进行均值比较,采用卡方检验进行比例比较。

结果

共有 6616 名患者就诊于 Alivio,其中 409 名患者被分诊至隔离区,378 名患者接受 COVID-19 检测;其中 148 名患者无症状,230 名患者有症状。在接受检测的患者中,161 名(42.6%)检测结果为阳性,占就诊患者总数的 2.4%。有症状患者的年龄、体温和脉搏率均显著高于无症状患者。症状分为 5 个集群:全身性症状 143 例(62%)、呼吸系统症状 136 例(59%)和躯体症状 97 例(42%)最为常见。没有任何一个症状集群对 COVID-19 具有特别的诊断意义,尽管有多个症状集群的患者更有可能检测结果阳性,<.001。大多数患者从事的是必要工作,没有医疗保险,超过一半的患者症状持续时间较长。

结论

西班牙裔患者在大流行期间有多种寻求医疗保健和检测的原因。COVID-19 是一种综合征疾病,这从症状的聚类中可以得到证明。必要工作和无保险的健康状况可能导致疾病持续时间延长。

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