Jude Mary Cénat , Elisabeth Dromer , Seyed Mohammad Mahdi Moshirian Farahi , Christa Masengesho Ndamage , Aiden Yun , Hannah Zuta , Jihane Mkhatri , Eden Samson , Raina Barara , Patrick R. Labelle , Yan Xu
{"title":"与白人、亚裔和其他种族患者相比,COVID-19 少数民族黑人患者的静脉血栓栓塞症:系统回顾和荟萃分析","authors":"Jude Mary Cénat , Elisabeth Dromer , Seyed Mohammad Mahdi Moshirian Farahi , Christa Masengesho Ndamage , Aiden Yun , Hannah Zuta , Jihane Mkhatri , Eden Samson , Raina Barara , Patrick R. Labelle , Yan Xu","doi":"10.1016/j.thromres.2024.05.007","DOIUrl":null,"url":null,"abstract":"<div><h3>Importance</h3><p>COVID-19 has disproportionately affected racialized populations, with particular impact among individuals of Black individuals. However, it is unclear whether disparities in venous thromboembolic (VTE) complications exist between Black individuals and those belonging to other racial groups with confirmed SARS-CoV2 infections.</p></div><div><h3>Objective</h3><p>To summarize the prevalence and moderators associated with VTE among Black COVID-19 patients in minoritized settings, and to compare this to White and Asian COVID-19 patients according to sex, age, and comorbid health conditions (heart failure, cancer, obesity, hypertension).</p></div><div><h3>Design setting, and participants</h3><p>A systematic search of MEDLINE, Embase, CINAHL and CENTRAL for articles or reports published from inception to February 15, 2023.</p></div><div><h3>Study selection</h3><p>Reports on VTE among Black individuals infected with SARS-CoV2, in countries where Black people are considered a minority population group.</p></div><div><h3>Data extraction and synthesis</h3><p>Study characteristics and results of eligible studies were independently extracted by 2 pairs of reviewers. VTE prevalence was extracted, and risk of bias was assessed. Prevalence estimates of VTE prevalence among Black individuals with COVID19 in each study were pooled. Where studies provided race-stratified VTE prevalence among COVID19 patients, odds ratios were generated using a random-effects model.</p></div><div><h3>Main outcomes and measures</h3><p>Prevalence of VTE, comprising of deep vein thrombosis and pulmonary embolism.</p></div><div><h3>Results</h3><p>Ten studies with 66,185 Black individuals reporting the prevalence of COVID-19 associated VTE were included. Weighted median age of included studies was 47.60. Pooled prevalence of COVID-19 associated VTE was 7.2 % (95 % CI, 3.8 % – 11.5 %) among Black individuals. Among individuals with SARS-CoV2 infections, Black population had higher risks of VTE compared to their White (OR = 1.79, [95 % CI 1.28–2.53], <em>p</em> < .001) or Asian (OR = 2.01, [95 % CI, 1.14–3.60], <em>p</em> = .017) counterparts, or patients with other racial identities (OR = 2.01, [95 % CI, 1.39, 2.92]; <em>p</em> < .001).</p></div><div><h3>Conclusions and relevance</h3><p>Black individuals with COVID-19 had substantially higher risk of VTE compared to White or Asian individuals. Given racial disparities in thrombotic disease burden related to COVID-19, medical education, research, and health policy interventions are direly needed to ensure adequate disease awareness among Black individuals, to facilitate appropriate diagnosis and treatment among Black patients with suspected and confirmed VTE, and to advocate for culturally safe VTE prevention strategies, including pre-existing inequalities to the COVID-19 pandemic that persist after the crisis.</p></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":null,"pages":null},"PeriodicalIF":3.7000,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0049384824001592/pdfft?md5=e7fc63f66e61b3c7d14e5d1bcd8fc709&pid=1-s2.0-S0049384824001592-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Venous thromboembolism in Black COVID-19 patients in a minority context compared to White, Asian and other racialized patients: A systematic review and meta-analysis\",\"authors\":\"Jude Mary Cénat , Elisabeth Dromer , Seyed Mohammad Mahdi Moshirian Farahi , Christa Masengesho Ndamage , Aiden Yun , Hannah Zuta , Jihane Mkhatri , Eden Samson , Raina Barara , Patrick R. Labelle , Yan Xu\",\"doi\":\"10.1016/j.thromres.2024.05.007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Importance</h3><p>COVID-19 has disproportionately affected racialized populations, with particular impact among individuals of Black individuals. However, it is unclear whether disparities in venous thromboembolic (VTE) complications exist between Black individuals and those belonging to other racial groups with confirmed SARS-CoV2 infections.</p></div><div><h3>Objective</h3><p>To summarize the prevalence and moderators associated with VTE among Black COVID-19 patients in minoritized settings, and to compare this to White and Asian COVID-19 patients according to sex, age, and comorbid health conditions (heart failure, cancer, obesity, hypertension).</p></div><div><h3>Design setting, and participants</h3><p>A systematic search of MEDLINE, Embase, CINAHL and CENTRAL for articles or reports published from inception to February 15, 2023.</p></div><div><h3>Study selection</h3><p>Reports on VTE among Black individuals infected with SARS-CoV2, in countries where Black people are considered a minority population group.</p></div><div><h3>Data extraction and synthesis</h3><p>Study characteristics and results of eligible studies were independently extracted by 2 pairs of reviewers. VTE prevalence was extracted, and risk of bias was assessed. Prevalence estimates of VTE prevalence among Black individuals with COVID19 in each study were pooled. Where studies provided race-stratified VTE prevalence among COVID19 patients, odds ratios were generated using a random-effects model.</p></div><div><h3>Main outcomes and measures</h3><p>Prevalence of VTE, comprising of deep vein thrombosis and pulmonary embolism.</p></div><div><h3>Results</h3><p>Ten studies with 66,185 Black individuals reporting the prevalence of COVID-19 associated VTE were included. Weighted median age of included studies was 47.60. Pooled prevalence of COVID-19 associated VTE was 7.2 % (95 % CI, 3.8 % – 11.5 %) among Black individuals. Among individuals with SARS-CoV2 infections, Black population had higher risks of VTE compared to their White (OR = 1.79, [95 % CI 1.28–2.53], <em>p</em> < .001) or Asian (OR = 2.01, [95 % CI, 1.14–3.60], <em>p</em> = .017) counterparts, or patients with other racial identities (OR = 2.01, [95 % CI, 1.39, 2.92]; <em>p</em> < .001).</p></div><div><h3>Conclusions and relevance</h3><p>Black individuals with COVID-19 had substantially higher risk of VTE compared to White or Asian individuals. Given racial disparities in thrombotic disease burden related to COVID-19, medical education, research, and health policy interventions are direly needed to ensure adequate disease awareness among Black individuals, to facilitate appropriate diagnosis and treatment among Black patients with suspected and confirmed VTE, and to advocate for culturally safe VTE prevention strategies, including pre-existing inequalities to the COVID-19 pandemic that persist after the crisis.</p></div>\",\"PeriodicalId\":23064,\"journal\":{\"name\":\"Thrombosis research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-05-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0049384824001592/pdfft?md5=e7fc63f66e61b3c7d14e5d1bcd8fc709&pid=1-s2.0-S0049384824001592-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Thrombosis research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0049384824001592\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Thrombosis research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0049384824001592","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEMATOLOGY","Score":null,"Total":0}
Venous thromboembolism in Black COVID-19 patients in a minority context compared to White, Asian and other racialized patients: A systematic review and meta-analysis
Importance
COVID-19 has disproportionately affected racialized populations, with particular impact among individuals of Black individuals. However, it is unclear whether disparities in venous thromboembolic (VTE) complications exist between Black individuals and those belonging to other racial groups with confirmed SARS-CoV2 infections.
Objective
To summarize the prevalence and moderators associated with VTE among Black COVID-19 patients in minoritized settings, and to compare this to White and Asian COVID-19 patients according to sex, age, and comorbid health conditions (heart failure, cancer, obesity, hypertension).
Design setting, and participants
A systematic search of MEDLINE, Embase, CINAHL and CENTRAL for articles or reports published from inception to February 15, 2023.
Study selection
Reports on VTE among Black individuals infected with SARS-CoV2, in countries where Black people are considered a minority population group.
Data extraction and synthesis
Study characteristics and results of eligible studies were independently extracted by 2 pairs of reviewers. VTE prevalence was extracted, and risk of bias was assessed. Prevalence estimates of VTE prevalence among Black individuals with COVID19 in each study were pooled. Where studies provided race-stratified VTE prevalence among COVID19 patients, odds ratios were generated using a random-effects model.
Main outcomes and measures
Prevalence of VTE, comprising of deep vein thrombosis and pulmonary embolism.
Results
Ten studies with 66,185 Black individuals reporting the prevalence of COVID-19 associated VTE were included. Weighted median age of included studies was 47.60. Pooled prevalence of COVID-19 associated VTE was 7.2 % (95 % CI, 3.8 % – 11.5 %) among Black individuals. Among individuals with SARS-CoV2 infections, Black population had higher risks of VTE compared to their White (OR = 1.79, [95 % CI 1.28–2.53], p < .001) or Asian (OR = 2.01, [95 % CI, 1.14–3.60], p = .017) counterparts, or patients with other racial identities (OR = 2.01, [95 % CI, 1.39, 2.92]; p < .001).
Conclusions and relevance
Black individuals with COVID-19 had substantially higher risk of VTE compared to White or Asian individuals. Given racial disparities in thrombotic disease burden related to COVID-19, medical education, research, and health policy interventions are direly needed to ensure adequate disease awareness among Black individuals, to facilitate appropriate diagnosis and treatment among Black patients with suspected and confirmed VTE, and to advocate for culturally safe VTE prevention strategies, including pre-existing inequalities to the COVID-19 pandemic that persist after the crisis.
期刊介绍:
Thrombosis Research is an international journal dedicated to the swift dissemination of new information on thrombosis, hemostasis, and vascular biology, aimed at advancing both science and clinical care. The journal publishes peer-reviewed original research, reviews, editorials, opinions, and critiques, covering both basic and clinical studies. Priority is given to research that promises novel approaches in the diagnosis, therapy, prognosis, and prevention of thrombotic and hemorrhagic diseases.