Internal Medicine Service, Hospital Universitario "12 de Octubre", Madrid, Spain.
1 Doctoral Student Rey Juan Carlos University, Madrid, Spain.
Pathog Glob Health. 2023 Sep;117(6):590-595. doi: 10.1080/20477724.2023.2174295. Epub 2023 Feb 12.
Previous studies have suggested an increased susceptibility of COVID-19 among certain populations. We analyzed whether COVID-19 presentation and mortality differ between Latinx migrants and Spanish natives.
COVID-19 patients between 35-64 years old admitted between January 26th-May-5th 2020 were reviewed. Demographics, major comorbidities, symptoms, signs and analytical parameters on admission were recorded. Respiratory failure was defined as PaO2/FiO2 ≤ 200 mmHg, noninvasive or invasive mechanical ventilation requirement at any time during hospitalization. A propensity score (PS) adjustment was created between Latinx and Spanish. A multivariable logistic regression model adjusted by the PS was performed to evaluate the effects of different variables on mortality.
894 patients: 425 (47.5%) Latinx and 469 (52.5%) Spanish natives were included. Latinx were younger (50 vs 55 years < 0.001) and had less comorbidities (29.4% vs 55.0% < 0.001) than Spanish natives. More often they exhibited fever (22.1% vs 9.8% = 0.018) and had higher inflammatory markers (PCR) (11.3 mg/dl vs 7.7 mg/dl < 0.001). Mortality seemed lower among Latinx (4.7% vs 8.7%, = 0.017). No association was found between ethnicity and mortality. Respiratory failure [OR = 23.978 (CI 95% 9.4-60.1) < 0.001], LDH [OR (per unitary increment) = 1.002; CI95% (1.000-1.004; = 0.036] and PCR [OR (per unitary increment) = 1.044 (CI95% 1.06-1.08); = 0.02] were independently associated to mortality.
We were unable to identify significant ethnic disparities between Latinx and Spanish natives in terms of COVID-19 mortality. Universal access to the health care system in Spain may have contributed to a better outcome of Latinx patients. Differences previously described might be a consequence of socioeconomic disparities.
先前的研究表明,某些人群更容易感染 COVID-19。本研究旨在分析拉丁裔移民和西班牙本地人的 COVID-19 表现和死亡率是否存在差异。
回顾了 2020 年 1 月 26 日至 5 月 5 日期间 35-64 岁之间因 COVID-19 入院的患者。记录了人口统计学、主要合并症、症状、体征和入院时的分析参数。呼吸衰竭定义为 PaO2/FiO2≤200mmHg,需要在住院期间的任何时间进行无创或有创机械通气。在拉丁裔和西班牙之间创建了倾向评分(PS)调整。使用 PS 调整的多变量逻辑回归模型评估不同变量对死亡率的影响。
共纳入 894 例患者,其中 425 例(47.5%)为拉丁裔,469 例(52.5%)为西班牙本地人。拉丁裔患者更年轻(50 岁 vs 55 岁,P<0.001)且合并症较少(29.4% vs 55.0%,P<0.001)。他们更常出现发热(22.1% vs 9.8%,P=0.018)且炎症标志物(PCR)更高(11.3mg/dl vs 7.7mg/dl,P<0.001)。拉丁裔的死亡率似乎较低(4.7% vs 8.7%,P=0.017)。但未发现种族与死亡率之间存在关联。呼吸衰竭[OR=23.978(95%CI95%9.4-60.1),P<0.001]、乳酸脱氢酶[OR(每单位递增)=1.002;95%CI95%(1.000-1.004),P=0.036]和 PCR[OR(每单位递增)=1.044(95%CI95%1.06-1.08),P=0.02]与死亡率独立相关。
我们未能发现拉丁裔和西班牙本地人在 COVID-19 死亡率方面存在显著的种族差异。西班牙全民享有医疗保健系统可能促成了拉丁裔患者的更好结局。先前描述的差异可能是社会经济差异的结果。