目的:评估COVID-19大流行对被监禁者(PEI)的影响,特别关注与普通人群相比的临床结果。
方法:根据审查和传播中心的良好做法指南进行系统审查,并进行叙述性综合。
方法:Medline,社会政策与实践,犯罪学联系,ASSIA,EMBASE,Scopus,网络科学,CINAHL,科克伦图书馆,CochraneCOVID-19评论,截至2022年10月21日,搜索了COVID-19证据审查和L*OVECOVID-19证据数据库。
方法:我们纳入了针对18岁以上被监禁的成年人的研究,暴露于SARS-CoV-2感染。所有与对照组的研究,不考虑研究设计和国家。没有比较组数据或没有测量临床结果/健康不平等的研究被排除。侧重于被拘留移民的研究,法医医院,监狱工作人员和非英语工作人员也被排除在外。
方法:两位评审员提取数据并评估偏倚风险。使用基于目标的框架分析对数据进行了叙事综合,感染率,测试,住院治疗,死亡率,疫苗摄取率和心理健康结果。没有荟萃分析的余地,由于现有证据的异质性。
结果:从数据库中导出了4516个参考文献,并搜索了灰色文献,其中55人符合纳入标准。大多数来自美国,是回顾性分析。与普通人群相比,通常发现PEI具有较高的SARS-CoV-2感染率和较差的临床结果。与一般人群相比,关于疫苗摄取和检测率的数据存在冲突。在大流行期间,PEI的心理健康下降。某些亚组受到COVID-19大流行的不利影响更大,如少数民族和老年人。
结论:PEI的COVID-19临床结局比一般公众差,主要表现在低质量的异质证据上。需要对持续的临床结果和适当的缓解干预措施进行进一步的高质量研究,以评估大流行对PEI的下游影响。然而,在监禁设施的背景下进行此类研究非常复杂且具有潜在挑战性。在未来大流行的情况下,为这一弱势群体确定资源的优先次序应该是国家政策的重点。
■CRD42022296968。
OBJECTIVE: To assess the effect of the COVID-19 pandemic on people experiencing incarceration (PEI), focusing particularly on clinical outcomes compared with the general population.
METHODS: Systematic
review with narrative synthesis in accordance with the Centre for Reviews and Dissemination\'s good practice guidelines.
METHODS: Medline, Social Policy and Practice, Criminology Connection, ASSIA, EMBASE, SCOPUS, Web Of Science, CINAHL, Cochrane Library, Cochrane COVID-19 reviews, COVID-19 Evidence Reviews and L*OVE COVID-19 Evidence databases were searched up to 21 October 2022.
METHODS: We included studies presenting data specific to adults ≥18 years experiencing incarceration, with exposure to SARS-CoV-2 infection. All studies with a comparison group, regardless of study design and country were included. Studies with no comparison group data or not measuring clinical outcomes/health inequalities were excluded. Studies focussing on detained migrants, forensic hospitals, prison staff and those not in English were also excluded.
METHODS: Two reviewers extracted data and assessed risk of bias. Data underwent narrative synthesis using a framework analysis based on the objectives, for infection rates, testing, hospitalisation, mortality, vaccine uptake rates and mental health outcomes. There was no scope for meta-analysis, due to the heterogeneity of evidence available.
RESULTS: 4516 references were exported from the databases and grey literature searched, of which 55 met the inclusion criteria. Most were from the USA and were retrospective analyses. Compared with the general population, PEI were usually found to have higher rates of SARS-CoV-2 infection and poorer clinical outcomes. Conflicting data were found regarding vaccine uptake and testing rates compared with the general population. The mental health of PEI declined during the pandemic. Certain subgroups were more adversely affected by the COVID-19 pandemic, such as ethnic minorities and older PEI.
CONCLUSIONS: PEI have poorer COVID-19 clinical outcomes than the general public, as shown by largely low-quality heterogenous evidence. Further high-quality research of continuing clinical outcomes and appropriate mitigating interventions is required to assess downstream effects of the pandemic on PEI. However, performing such research in the context of incarceration facilities is highly complex and potentially challenging. Prioritisation of resources for this vulnerable group should be a focus of national policy in the event of future pandemics.
UNASSIGNED: CRD42022296968.