■荟萃分析调查了种族和民族与COVID-19结果之间的关联。然而,这些关联的存在是不确定的,量级,和证据水平。我们,因此,旨在合成,量化、并对美国种族和族裔和COVID-19结局的证据强度进行分级。
■在这篇综述中,我们搜索了四个数据库(Pubmed,Embase,Cochrane系统评价数据库,和Epistemonikos)从数据库开始到2022年4月。每个荟萃分析的方法学质量都是使用多重系统评价来评估的,版本2(AMSTAR-2)。根据既定标准,种族和族裔与结果之间关联的证据强度被认为令人信服,高度暗示性,暗示,弱,或不重要。研究方案在PROSPERO注册,CRD4202236805。
■在筛选的880条记录中,我们选择了七个荟萃分析进行证据综合,与42个协会进行了审查。总的来说,42个关联中有10个具有统计学意义(p≤0.05)。两个协会高度暗示,两个是暗示性的,两个人很虚弱,而其余32个关联无统计学意义.与白人相比,黑人个体感染COVID-19的风险更高(风险比,2.08,95%置信区间(CI),1.60-2.71),这得到了高度暗示性的证据的支持;根据敏感性分析的保守估计,这种联系仍然具有启发性。在感染COVID-19的人群中,西班牙裔个体比非西班牙裔白人个体住院的风险更高(赔率比,2.08,95%CI,1.60-2.70),敏感性分析后仍有高度暗示性的证据。
与白人相比,黑人和西班牙裔人群感染COVID-19和住院的风险更高。这些种族和民族与COVID-19结局的关联在住院前阶段更为明显。在这一阶段应该更多地考虑解决健康不平等问题。
Meta-analyses have investigated associations between race and ethnicity and COVID-19 outcomes. However, there is uncertainty about these associations\' existence, magnitude, and level of evidence. We, therefore, aimed to synthesize, quantify, and grade the strength of evidence of race and ethnicity and COVID-19 outcomes in the US.
In this umbrella
review, we searched four databases (Pubmed, Embase, the Cochrane Database of Systematic Reviews, and Epistemonikos) from database inception to April 2022. The methodological quality of each meta-analysis was assessed using the Assessment of Multiple Systematic Reviews, version 2 (AMSTAR-2). The strength of evidence of the associations between race and ethnicity with outcomes was ranked according to established criteria as convincing, highly suggestive, suggestive, weak, or non-significant. The study protocol was registered with PROSPERO, CRD42022336805.
Of 880 records screened, we selected seven meta-analyses for evidence synthesis, with 42 associations examined. Overall, 10 of 42 associations were statistically significant (p ≤ 0.05). Two associations were highly suggestive, two were suggestive, and two were weak, whereas the remaining 32 associations were non-significant. The risk of COVID-19 infection was higher in Black individuals compared to White individuals (risk ratio, 2.08, 95% Confidence Interval (CI), 1.60-2.71), which was supported by highly suggestive evidence; with the conservative estimates from the sensitivity analyses, this association remained suggestive. Among those infected with COVID-19, Hispanic individuals had a higher risk of COVID-19 hospitalization than non-Hispanic White individuals (odds ratio, 2.08, 95% CI, 1.60-2.70) with highly suggestive evidence which remained after sensitivity analyses.
Individuals of Black and Hispanic groups had a higher risk of COVID-19 infection and hospitalization compared to their White counterparts. These associations of race and ethnicity and COVID-19 outcomes existed more obviously in the pre-hospitalization stage. More consideration should be given in this stage for addressing health inequity.