Department of Internal Medicine, Sint Antonius Hospital, Nieuwegein, The Netherlands.
Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands.
PLoS One. 2023 Apr 5;18(4):e0284036. doi: 10.1371/journal.pone.0284036. eCollection 2023.
Since the beginning of the SARS-CoV-2 pandemic, studies have been reporting inconsistently on migration background as a risk factor for COVID-19 outcomes. The aim of this study was to evaluate the association between migration background and clinical outcomes with COVID-19 in the Netherlands.
This cohort study included 2,229 adult COVID-19 patients admitted in two Dutch hospitals between February 27, 2020 and March 31, 2021. Odds ratios (ORs) for hospital admission, intensive care unit (ICU) admission and mortality with 95% confidence intervals (CIs) were calculated for non-Western (Moroccan, Turkish, Surinamese or other) persons as compared with Western persons in the general population of the province of Utrecht (the Netherlands) as source population. Furthermore, among hospitalized patients, Hazard ratios (HRs) with 95% CIs for in-hospital mortality and intensive care unit (ICU) admission were calculated using Cox proportional hazard analyses. Hazard ratios were adjusted for age, sex, body mass index, hypertension, Charlson Comorbidity Index, chronic corticosteroid use before admission, income, education and population density to investigate explanatory variables.
Of the 2,229 subjects, 1,707 were of Western origin and 522 were of non-Western origin. There were 313 in-hospital deaths and 503 ICU admissions. As compared with persons with a Western origin in the general population of the province of Utrecht, the ORs for non-Western persons was 1.8 (95% CI 1.7-2.0) for hospitalization, 2.1 (95% CI 1.7-2.5) for ICU admission and 1.3 (95% CI 1.0-1.7) for mortality. Among hospitalized patients, HR for ICU admission was 1.1 (95% CI 0.9-1.4) and 0.9 (95% CI 0.7-1.3) for mortality for non-Western hospitalized persons as compared with hospitalized patients of Western origin after adjustment.
Non-Western persons, including Moroccan, Turkish and Surinamese subjects, had increased risks of hospital admission, ICU admission and COVID-19 related death on a population level. Among hospitalized COVID-19 patients, no association was found between migration background and ICU admission or mortality.
自 SARS-CoV-2 大流行开始以来，研究报告显示，移民背景是 COVID-19 结局的一个不一致的风险因素。本研究的目的是评估在荷兰，移民背景与 COVID-19 的临床结局之间的关系。
这项队列研究纳入了 2020 年 2 月 27 日至 2021 年 3 月 31 日期间在荷兰两家医院住院的 2229 名成年 COVID-19 患者。使用多变量 Cox 比例风险分析，调整了年龄、性别、体重指数、高血压、Charlson 合并症指数、入院前慢性皮质类固醇使用、收入、教育和人口密度等解释变量后，计算了非西方（摩洛哥、土耳其、苏里南或其他）人与西方（乌得勒支省荷兰一般人群）人群相比，住院、入住重症监护病房（ICU）和死亡的比值比（ORs）及 95%置信区间（CI）。此外，对于住院患者，还使用 Cox 比例风险分析计算了院内死亡率和 ICU 入住率的危害比（HRs）及其 95%CI。
在 2229 名患者中，有 1707 名来自西方，522 名来自非西方。有 313 例院内死亡，503 例 ICU 入住。与乌得勒支省荷兰一般人群中的西方人相比，非西方人的住院 OR 为 1.8（95%CI 1.7-2.0），ICU 入住 OR 为 2.1（95%CI 1.7-2.5），死亡率 OR 为 1.3（95%CI 1.0-1.7）。在住院患者中，非西方住院患者 ICU 入住率的 HR 为 1.1（95%CI 0.9-1.4），死亡率 HR 为 0.9（95%CI 0.7-1.3），与西方住院患者相比。
在人群水平上，非西方人群（包括摩洛哥、土耳其和苏里南人）住院、入住 ICU 和 COVID-19 相关死亡的风险增加。在 COVID-19 住院患者中，移民背景与 ICU 入住或死亡率之间没有关联。
