Mozaffari Essy, Chandak Aastha, Amin Alpesh N, Gottlieb Robert L, Kalil Andre C, Sarda Vishnudas, Berry Mark, Brown Gina, Okulicz Jason F, Chima-Melton Chidinma
Gilead Sciences, Foster City, CA, USA.
Certara, New York, NY, USA.
J Racial Ethn Health Disparities. 2025 Apr;12(2):1052-1062. doi: 10.1007/s40615-024-01942-0. Epub 2024 Feb 26.
Racial and ethnic disparities in patient outcomes following COVID-19 exist, in part, due to factors involving healthcare delivery. The aim of the study was to characterize disparities in the administration of evidence-based COVID-19 treatments among patients hospitalized for COVID-19.
Using a large, US hospital database, initiation of COVID-19 treatments was compared among patients hospitalized for COVID-19 between May 2020 and April 2022 according to patient race and ethnicity. Multivariate logistic regression models were used to examine the effect of race and ethnicity on the likelihood of receiving COVID-19 treatments, stratified by baseline supplemental oxygen requirement.
The identified population comprised 317,918 White, 76,715 Black, 9297 Asian, and 50,821 patients of other or unknown race. There were 329,940 non-Hispanic, 74,199 Hispanic, and 50,622 patients of unknown ethnicity. White patients were more likely to receive COVID-19 treatments, and specifically corticosteroids, compared to Black, Asian, and other patients (COVID-19 treatment: 87% vs. 81% vs. 85% vs. 84%, corticosteroids: 85% vs. 79% vs. 82% vs. 82%). After covariate adjustment, White patients were significantly more likely to receive COVID-19 treatments than Black patients across all levels of supplemental oxygen requirement. No clear trend in COVID-19 treatments according to ethnicity (Hispanic vs. non-Hispanic) was observed.
There were important racial disparities in inpatient COVID-19 treatment initiation, including the undertreatment of Black patients and overtreatment of White patients. Our new findings reveal the actual magnitude of this issue in routine clinical practice to clinicians, policymakers, and guideline developers. This is crucial to ensuring equitable and appropriate access to evidence-based therapies.
新冠病毒病（COVID-19）患者的治疗结果存在种族和族裔差异，部分原因涉及医疗服务提供方面的因素。本研究的目的是描述因COVID-19住院患者中基于证据的COVID-19治疗用药方面的差异。
利用一个大型美国医院数据库，比较了2020年5月至2022年4月期间因COVID-19住院的患者根据种族和族裔接受COVID-19治疗的情况。采用多变量逻辑回归模型，按基线补充氧气需求分层，研究种族和族裔对接受COVID-19治疗可能性的影响。
确定的人群包括317,918名白人、76,715名黑人、9297名亚洲人以及50,821名其他种族或种族不明的患者。有329,940名非西班牙裔、74,199名西班牙裔以及50,622名族裔不明的患者。与黑人、亚洲人和其他患者相比，白人患者更有可能接受COVID-19治疗，尤其是皮质类固醇（COVID-19治疗：87%对81%对85%对84%，皮质类固醇：85%对79%对82%对82%）。在进行协变量调整后，在所有补充氧气需求水平上，白人患者比黑人患者接受COVID-19治疗的可能性显著更高。未观察到根据族裔（西班牙裔与非西班牙裔）在COVID-19治疗方面的明显趋势。
住院COVID-19治疗的起始存在重要的种族差异，包括黑人患者治疗不足和白人患者治疗过度。我们的新发现向临床医生、政策制定者和指南制定者揭示了这一问题在常规临床实践中的实际严重程度。这对于确保公平且适当地获得基于证据的治疗至关重要。
