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在一个中美大西洋地区医疗体系中,因 COVID-19 住院的少数族裔患者在死亡率方面不存在种族和民族差异。

Lack of racial and ethnic disparities in mortality in minority patients hospitalised with COVID-19 in a mid-Atlantic healthcare system.

机构信息

Johns Hopkins Medicine, Baltimore, Maryland, USA.

Johns Hopkins University, Baltimore, Maryland, USA.

出版信息

BMJ Open Respir Res. 2024 May 1;11(1):e002310. doi: 10.1136/bmjresp-2024-002310.

Abstract

INTRODUCTION

In the USA, minoritised communities (racial and ethnic) have suffered disproportionately from COVID-19 compared with non-Hispanic white communities. In a large cohort of patients hospitalised for COVID-19 in a healthcare system spanning five adult hospitals, we analysed outcomes of patients based on race and ethnicity.

METHODS

This was a retrospective cohort analysis of patients 18 years or older admitted to five hospitals in the mid-Atlantic area between 4 March 2020 and 27 May 2022 with confirmed COVID-19. Participants were divided into four groups based on their race/ethnicity: non-Hispanic black, non-Hispanic white, Latinx and other. Propensity score weighted generalised linear models were used to assess the association between race/ethnicity and the primary outcome of in-hospital mortality.

RESULTS

Of the 9651 participants in the cohort, more than half were aged 18-64 years old (56%) and 51% of the cohort were females. Non-Hispanic white patients had higher mortality (p<0.001) and longer hospital length-of-stay (p<0.001) than Latinx and non-Hispanic black patients.

DISCUSSION

In this large multihospital cohort of patients admitted with COVID-19, non-Hispanic black and Hispanic patients did not have worse outcomes than white patients. Such findings likely reflect how the complex range of factors that resulted in a life-threatening and disproportionate impact of incidence on certain vulnerable populations by COVID-19 in the community was offset through admission at well-resourced hospitals and healthcare systems. However, there continues to remain a need for efforts to address the significant pre-existing race and ethnicity inequities highlighted by the COVID-19 pandemic to be better prepared for future public health emergencies.

摘要

简介

在美国,少数族裔(种族和族裔)因 COVID-19 而遭受的影响与非西班牙裔白人社区不成比例。在一个横跨五家成人医院的医疗系统中,我们对因 COVID-19 住院的大量患者进行了分析,根据种族和族裔分析了患者的结局。

方法

这是一项回顾性队列分析,纳入了 2020 年 3 月 4 日至 2022 年 5 月 27 日期间在中大西洋地区五家医院因确诊 COVID-19 住院的 18 岁或以上患者。参与者根据其种族/族裔分为四组:非西班牙裔黑人、非西班牙裔白人、拉丁裔和其他。使用倾向评分加权广义线性模型评估种族/族裔与主要结局院内死亡率之间的关联。

结果

队列中的 9651 名参与者中,超过一半年龄在 18-64 岁之间(56%),51%的患者为女性。非西班牙裔白人患者的死亡率(p<0.001)和住院时间(p<0.001)均高于拉丁裔和非西班牙裔黑人患者。

讨论

在这项针对因 COVID-19 住院的大型多医院队列研究中,非西班牙裔黑人患者和西班牙裔患者的结局并未比白人患者差。这些发现可能反映了社区中 COVID-19 导致危及生命和不成比例的发病率对某些弱势群体的影响的一系列复杂因素,这些因素通过在资源充足的医院和医疗系统中入院得到了缓解。然而,仍然需要努力解决 COVID-19 大流行凸显的重大种族和族裔不平等问题,为未来的公共卫生紧急情况做好更好的准备。

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