种族会影响新冠肺炎住院患者深静脉血栓形成、肺栓塞和急性肾损伤的不良结局。

OBJECTIVE: The purpose of the present study was to explore the racial disparities in the incidence of deep vein thrombosis (DVT), pulmonary embolism (PE), and acute kidney injury (AKI) in hospitalized patients with coronavirus disease 2019 (COVID-19). METHODS: A retrospective analysis was performed of prospectively collected data of consecutive COVID-19 patients hospitalized from March 11, 2020 to May 27, 2021. The primary outcome measures were the incidence of DVT/PE and mortality. The secondary outcome measures included differences in the length of hospitalization, need for intensive care unit care, readmission, and AKI. Multivariable regression models were used to assess for independent predictors of the primary and secondary outcome measures. RESULTS: The present study included 876 hospitalized patients with COVID-19. The mean age was 64.4 ± 16.2 years, and 355 were women (40.5%). Of the 876 patients, 694 (79.2%) had identified as White, 111 (12.7%) as Black/African American, 48 (5.5%) as Asian, and 23 (2.6%) as other. The overall incidence of DVT/PE was 8.7%. The DVT/PE incidence rates differed across the race groups and was highest for Black/African American patients (n = 18; 16.2%), followed by Asian patients (n = 5; 10.4%), White patients (n = 52; 7.5%), and other (n = 1; 4.4%; P = .03). All but one of the hospitalization outcomes examined demonstrated no differences according to race, including the hospitalization stay (P = .33), need for intensive care unit care (P = .20), readmission rates (P = .52), and hospital all-cause mortality (P = .29). The AKI incidence differed among races, affecting a higher proportion of Black/African American patients (P=.003). On multivariable regression analysis, Black/African American race (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.0-4.0; P = .04) and higher D-dimer levels (OR, 1.1; 95% CI, 1.1-1.2; P < .0001) were predictors of DVT/PE. In addition, Black/African American race (OR, 2.3; 95% CI, 1.4-3.7; P = .001), lower hemoglobin levels (OR, 0.84; 95% CI, 0.8-0.9; P ≤ .0001), male sex (OR, 1.7; 95% CI, 1.2-2.4; P = .005), hypertension (OR, 2.1; 95% CI, 1.4-3.1; P = .0005), and older age (OR, 1.02; 95% CI, 1.006-1.03; P = .003) were predictors of AKI. CONCLUSIONS: In our single-center case series, we found a higher incidence of DVT/PE and AKI among Black/African American patients with COVID-19. Black/African American race and D-dimer levels were independent predictors of DVT/PE, and Black/African American race, hemoglobin, and D-dimer levels were independent predictors of AKI.

目的：本研究旨在探讨 2019 年冠状病毒病（COVID-19）住院患者深静脉血栓形成（DVT）、肺栓塞（PE）和急性肾损伤（AKI）发生率的种族差异。

方法：对 2020 年 3 月 11 日至 2021 年 5 月 27 日连续住院的 COVID-19 患者前瞻性收集的数据进行回顾性分析。主要结局指标为 DVT/PE 的发生率和死亡率。次要结局指标包括住院时间、需要重症监护病房治疗、再入院和 AKI 的差异。多变量回归模型用于评估主要和次要结局指标的独立预测因素。

结果：本研究纳入了 876 例 COVID-19 住院患者。平均年龄为 64.4±16.2 岁，其中 355 例为女性（40.5%）。876 例患者中，694 例（79.2%）为白人，111 例（12.7%）为黑人/非裔美国人，48 例（5.5%）为亚洲人，23 例（2.6%）为其他种族。DVT/PE 的总发生率为 8.7%。不同种族 DVT/PE 的发生率不同，黑人/非裔美国人患者发生率最高（n=18；16.2%），其次是亚洲人（n=5；10.4%）、白人（n=52；7.5%）和其他（n=1；4.4%；P=.03）。除住院时间（P=.33）、需要重症监护病房治疗（P=.20）、再入院率（P=.52）和医院全因死亡率（P=.29）外，所有其他住院结局检查均无差异。种族之间 AKI 的发生率不同，黑人/非裔美国人患者的比例较高（P=.003）。多变量回归分析显示，黑人/非裔美国人种族（比值比[OR]，2.0；95%置信区间[CI]，1.0-4.0；P=.04）和较高的 D-二聚体水平（OR，1.1；95%CI，1.1-1.2；P<.0001）是 DVT/PE 的预测因素。此外，黑人/非裔美国人种族（OR，2.3；95%CI，1.4-3.7；P=.001）、较低的血红蛋白水平（OR，0.84；95%CI，0.8-0.9；P≤.0001）、男性（OR，1.7；95%CI，1.2-2.4；P=.005）、高血压（OR，2.1；95%CI，1.4-3.1；P=.0005）和年龄较大（OR，1.02；95%CI，1.006-1.03；P=.003）是 AKI 的预测因素。

结论：在我们的单中心病例系列研究中，我们发现 COVID-19 黑人/非裔美国患者 DVT/PE 和 AKI 的发生率较高。黑人/非裔美国人种族和 D-二聚体水平是 DVT/PE 的独立预测因素，而黑人/非裔美国人种族、血红蛋白和 D-二聚体水平是 AKI 的独立预测因素。

新学期，新优惠

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新学期，新优惠

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Race affects adverse outcomes of deep vein thrombosis, pulmonary embolism, and acute kidney injury in coronavirus disease 2019 hospitalized patients.

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