bims-covirf Biomed News
on COVID19 risk factors
Issue of 2021–11–07
two papers selected by
Catherine Rycroft, BresMed
  1. Ethnic minority status as social determinant for COVID-19 infection, hospitalisation, severity, ICU admission and deaths in the early phase of the pandemic: a meta-analysis.
  2. Risk Factors of COVID-19 Critical Outcomes in the Eastern Mediterranean Region: A Multicountry Retrospective Study .
  1. BMJ Glob Health. 2021 Nov;pii: e007433. [Epub ahead of print]6(11):
    Ethnic minority status as social determinant for COVID-19 infection, hospitalisation, severity, ICU admission and deaths in the early phase of the pandemic: a meta-analysis.
    Charles Agyemang, Anke Richters, Shahab Jolani, Stevie Hendriks, Saurabh Zalpuri, Evan Yu, Bart Pijls, Maria Prins, Karien Stronks, Maurice P Zeegers.
       INTRODUCTION: Early literature on the COVID-19 pandemic indicated striking ethnic inequalities in SARS-CoV-2-related outcomes. This systematic review and meta-analysis aimed to describe the presence and magnitude of associations between ethnic groups and COVID-19-related outcomes.
    METHODS: PubMed and Embase were searched from December 2019 through September 2020. Studies reporting extractable data (ie, crude numbers, and unadjusted or adjusted risk/ORs) by ethnic group on any of the five studied outcomes: confirmed COVID-19 infection in the general population, hospitalisation among infected patients, and disease severity, intensive care unit (ICU) admission and mortality among hospitalised patients with SARS-CoV-2 infection, were included using standardised electronic data extraction forms. We pooled data from published studies using random-effects meta-analysis.
    RESULTS: 58 studies were included from seven countries in four continents, mostly retrospective cohort studies, covering a total of almost 10 million individuals from the first wave until the summer of 2020. The risk of diagnosed SARS-CoV-2 infection was higher in most ethnic minority groups than their White counterparts in North American and Europe with the differences remaining in the US ethnic minorities after adjustment for confounders and explanatory factors. Among people with confirmed infection, African-Americans and Hispanic-Americans were also more likely than White-Americans to be hospitalised with SARS-CoV-2 infection. No increased risk of COVID-19 outcomes (ie, severe disease, ICU admission and death) was found among ethnic minority patients once hospitalised, except for a higher risk of death among ethnic minorities in Brazil.
    CONCLUSION: The risk of SARS-CoV-2 diagnosis was higher in most ethnic minorities, but once hospitalised, no clear inequalities exist in COVID-19 outcomes except for the high risk of death in ethnic minorities in Brazil. The findings highlight the necessity to tackle disparities in social determinants of health, preventative opportunities and delay in healthcare use. Ethnic minorities should specifically be considered in policies mitigating negative impacts of the pandemic.
    PROSPERO REGISTRATION NUMBER: CRD42020180085.
    Keywords:  COVID-19; SARS; public health; systematic review
    DOI:  https://doi.org/10.1136/bmjgh-2021-007433
  2. JMIR Public Health Surveill. 2021 Oct 05.
    Risk Factors of COVID-19 Critical Outcomes in the Eastern Mediterranean Region: A Multicountry Retrospective Study .
    Faris Lami, Maisa Elfadul, Hiba Abdulrahman Rashak, Mohannad Al Nsour, Hashaam Akhtar, Yousef S Khader, Ahmed Mohamud Hussein, Mariam Naciri, Sahar Samy, Yasser Ghaleb, Hana Ahmad Taha, Alaa Hussein Aljanabe, Nameer Abdulkareem Ali, Raheem Hussein Zayer, Aamer Ikram, Fazal Ur Rahman, Muhammad Mujeeb Khan, Reema Adam, Abdirizak Yusuf Ahmed, Salma Afifi.
       BACKGROUND: The establishment of empirical evidence in the Eastern Mediterranean Region (EMR) necessitates the implementation of wide-scale studies to describe the demographic, clinical features, and severity profile of COVID-19 patients.
    OBJECTIVE: This study aimed to assess the patterns of COVID-19 severity and mortality in seven countries and to determine the risk factors of COVID-19 severity and mortality.
    METHODS: This multi-country study was based on a retrospective review of medical records of hospitalized patients confirmed to have COVID-19. This study included data from Iraq, Pakistan, Sudan, Somalia, Morocco, Egypt, and Yemen. All demographic and clinical data were extracted from hospital records (paper files) by trained data collectors.
    RESULTS: A total of 4141 patients were included in this study from seven countries. Comorbidities were reported by nearly half of the patients, with hypertension (HT) (24.7%) and diabetes (22.7%) being the most common. Older age, diabetes mellitus, hypertension, and heart diseases were significantly associated with COVID-19 severity and mortality. Ever smoking and renal diseases were significantly associated with severity but not mortality, while male gender, respiratory diseases, and malignancy were significantly associated with mortality but not severity.
    CONCLUSIONS: The study confirmed the role of comorbidities and demographic features on the severity and mortality of COVID-19. Understanding the contributing factors ensures attentive care and informs clinical management of patients with poorer prognoses in the early stages of diseases.
    DOI:  https://doi.org/10.2196/32831
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