Racial and Ethnic Disparities and the National Burden of COVID-19 on Inpatient Hospitalizations: A Retrospective Study in the United States in the Year 2020.

IF 3.2 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Racial and Ethnic Health Disparities Pub Date : 2024-09-24 DOI:10.1007/s40615-024-02069-y

Amanda Nguyen, Russell G Buhr, Gregg C Fonarow, Jeffrey J Hsu, Arleen F Brown, Boback Ziaeian

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Abstract

Background: Since January 2020, COVID-19 has affected more than 100 million people in the U.S. Previous studies on racial and ethnic disparities related to characteristics and outcomes of COVID-19 patients have been insightful. However, appropriate epidemiologic age-standardization of the disease burden and disparities for hospitalization data are lacking.

Objective: To identify and describe racial and ethnic disparities for primary COVID-19 hospitalizations in the U.S. in 2020.

Methods: In this nationally representative observational study, we use the National Inpatient Sample to quantify racial and ethnic disparities in COVID-19 hospitalizations. Descriptive statistics for patient characteristics, common comorbidities, age-standardized hospitalization rates, inpatient complications, and mortality among COVID-19 hospitalizations were contrasted by race and ethnicity.

Results: There were 1,058,815 primary COVID-19 hospitalizations in 2020. Of those, 47.2% were female, with median age of 66 (IQR, 54, 77). Overall inpatient mortality rate was 11.1%. When compared to White patients, Black, Hispanic, and Native American patients had higher age-standardized hospitalization rate ratios of 2.42 (95% CI 2.40-2.43), 2.26 (2.25-2.28), and 2.51 (2.46-2.56), respectively. Non-White patients had increased age-adjusted rates for procedures and complications. Factors associated with inpatient mortality include age, male sex, Hispanic or Native American race or ethnicity, lower income, Medicaid, heart failure, arrhythmias, coagulopathy, and chronic liver disease.

Conclusions: Marginalized populations in the U.S. had over twice the COVID-19 hospitalization rate relative to White patients. Age-adjusted mortality rates were highest for Black, Hispanic, and Native American patients. Careful consideration for vulnerable populations is encouraged during highly communicable respiratory pandemics.

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种族和民族差异以及 COVID-19 对住院病人造成的全国性负担：2020 年美国的回顾性研究》。

背景：自 2020 年 1 月以来，COVID-19 已影响到美国 1 亿多人。此前有关 COVID-19 患者特征和预后的种族和民族差异的研究颇有见地。然而，目前还缺乏对疾病负担和住院数据差异进行适当的流行病学年龄标准化：确定并描述 2020 年美国 COVID-19 初诊住院患者的种族和民族差异：在这项具有全国代表性的观察性研究中，我们使用全国住院病人样本来量化 COVID-19 住院治疗中的种族和民族差异。我们按种族和民族对 COVID-19 住院患者的特征、常见合并症、年龄标准化住院率、住院并发症和死亡率进行了描述性统计：结果：2020 年，COVID-19 初次住院人数为 1,058,815 人。其中 47.2% 为女性，年龄中位数为 66 岁（IQR，54，77）。住院病人总死亡率为 11.1%。与白人患者相比，黑人、西班牙裔和美国本土患者的年龄标准化住院率比率较高，分别为 2.42 (95% CI 2.40-2.43)、2.26 (2.25-2.28) 和 2.51 (2.46-2.56)。经年龄调整后，非白人患者的手术率和并发症发生率均有所上升。与住院病人死亡率相关的因素包括年龄、男性、西班牙裔或美国原住民种族或族裔、低收入、医疗补助、心力衰竭、心律失常、凝血功能障碍和慢性肝病：美国边缘化人群的COVID-19住院率是白人患者的两倍多。黑人、西班牙裔和美国原住民患者的年龄调整后死亡率最高。在高度传染性的呼吸道传染病流行期间，应仔细考虑易感人群。

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来源期刊

Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

5.10%

发文量

263

期刊介绍： Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.