Racism, Not Race, Drives Inequity Across the COVID-19 Continuum

Khazanchi, Rohan; Evans, Charlesnika T.; Marcelin, Jasmine R.

doi:10.1001/jamanetworkopen.2020.19933

Cited by 189 publications

(208 citation statements)

References 8 publications

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“…They explained that accessibility to services in comprehensive health care environment may attenuate, if not eliminate, racial/ethnic differences in COVID‐19 mortality rates. Finally, Khazanchi et al, in a communication in JAMA, argued that racism rather than race may explain COVID‐19‐associated racial health inequities 25 . They wrote, “…rather than validating long‐debunked hypotheses about intrinsic biologic susceptibilities among non‐white racial groups, the evidence to date reaffirms that structural racism is a critical driving force behind COVID‐19 disparities”.…”

Section: Discussionmentioning

confidence: 99%

Favorable outcome of COVID‐19 among African American (AA) renal transplant recipients in Detroit

Tejada

Zachariah

Cruz

et al. 2020

Clinical Transplantation

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Transplant recipients are vulnerable to infections, including COVID‐19, given their comorbidities and chronic immunosuppression. In this study, all hospitalized renal transplant recipients (RTR) with a positive nasal swab for Severe Acute Respiratory Syndrome‐Coronavirus‐2 (SARS‐CoV2) seen consecutively between 03/01/2020 and 05/01/2020 at the Detroit Medical Center were included. Data on demographics, clinical presentation, laboratory findings, management, and outcomes were collected. Twenty‐five patients were included, all African American (AA) and deceased‐donor transplant recipients. The most common presenting symptom was dyspnea, followed by fever, cough and diarrhea. Multifocal opacities on initial chest x‐ray were seen in 52% patients and 44% of patients had a presenting oxygen saturation of less than or equal to 94%. Four patients (16%) required transfer to the intensive care unit, one required intubation and one expired. COVID‐19‐infected RTR in this cohort had low mortality of 4% ( n = 1). Despite multiple comorbidities and chronic immunosuppression, our cohort of African American RTR had favorable outcomes compared to other reports on COVID‐19 in RTR.

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Section: Discussionmentioning

confidence: 99%

Favorable outcome of COVID‐19 among African American (AA) renal transplant recipients in Detroit

Tejada

Zachariah

Cruz

et al. 2020

Clinical Transplantation

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“…2,216 The COVID-19 pandemic has magnified the impact of health disparities and barriers to health care experienced by marginalized populations around the world. Consequently, COVID-19 has disproportionately affected Indigenous communities, Black and Hispanic populations 4,6,[217][218][219] , comparable to what has been identified in patients with SLE and COVID-19. 192,220 Interestingly, a recent study suggested African ancestry populations showed a genetic predisposition for lower expression of both ACE2 andD 1 7 8 X X type 2 transmembrane serine proteaseD 1 7 9 X X, suggesting decreased susceptibility to contracting SARS-CoV-2 in this population 221 .…”

Section: Ancestral Background Socioeconomic Factors and Indirect Conmentioning

confidence: 99%

“… 2 SLE is more prevalent and severe in ancestrally African and Hispanic patients, which overlaps with high-risk groups associated with poor outcomes of COVID-19, although the association with the latter may be mediated more by social determinants of health as opposed to biologic factors. 3 , 4 , 5 , 6 In contrast, SLE is a female-predominant disease which may represent a protective factor, as COVID-19 has been shown to affect males more severely. 3 , 7 , 8 , 9 , 10 One interesting feature is that inflammation in SLE is often characterized by elevation of type I interferon (IFN), which has antiviral properties and could potentially be protective.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 in patients with systemic lupus erythematosus: lessons learned from the inflammatory disease

Fernández-Ruiz

Paredes

Niewold

2021

Translational Research

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As the world navigates the Coronavirus disease 2019 (COVID-19) pandemic, there is a growing need to assess its impact in patients with autoimmune rheumatic diseases, such as systemic lupus erythematosus (SLE). Patients with SLE are a unique population when considering the risk of contracting COVID-19 and infection outcomes. The use of systemic glucocorticoids and immunosuppressants, and underlying organ damage from SLE are potential susceptibility factors. Most patients with SLE have evidence of high type I IFN activity, which may theoretically act as an antiviral line of defense or contribute to the development of a deleterious hyperinflammatory response in COVID-19. Other immunopathogenic mechanisms of SLE may overlap with those described in COVID-19, and thus studies in SLE could provide some insight into immune responses occurring in severe cases of the viral infection. We reviewed the literature to date on COVID-19 in patients with SLE and provide an in-depth review of current research in the area, including immune pathway activation, epidemiology, clinical features, outcomes, and the psychosocial impact of the pandemic in those with autoimmune disease.

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“…Ethnicity-based health disparities have been central to the public health discourse in the past decades [1][2][3] and have remained so, particularly amid the current COVID-19 pandemic [4][5][6][7]. Major risk factors for hospitalization, severity and mortality of COVID-19 include diet-related conditions, such as obesity, hypertension and type 2 diabetes, which have been shown to disproportionally affect the most vulnerable [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Deteriorated Dietary Patterns with Regards to Health and Environmental Sustainability among Hungarian Roma Are Not Differentiated from Those of the General Population

et al. 2021

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Nutritional epidemiology studies on Roma people are scarce and, to date, their nutrient-based dietary patterns with regards to both healthy and sustainable dietary considerations have never been reported. We report, for the first time, adherence to healthy and sustainable dietary patterns using scoring and regression models, based on recommendations defined by the World Health Organization, in the Dietary Approaches to Stop Hypertension (DASH) study and the EAT-Lancet report, as well as dietary quality based on Dietary Inflammatory Index (DII) among the Hungarian Roma (HR) population living in North East Hungary, with Hungarian general (HG) adults as reference. Data were obtained from a complex, comparative health survey involving dietary assessment, structured questionnaire-based interview, physical and laboratory examinations on 359 HG and 344 HR subjects in Northeast Hungary. Poisson regressions were fit to models that included DASH, EAT, DII and Healthy Diet Indicator as dependent variables to assess the influence of ethnicity on healthy and sustainable nutrient-based patterns. Adjusted models controlled for all relevant covariates using the residual method indicated poor dietary quality with regards to the selected dietary patterns. These associations were not ethnicity-sensitive, except for DII, where Roma ethnicity was linked to a decrease of DII score (β = −0.455, 95%CI: −0.720; −0.191, p < 0.05). Currently, HR dietary patterns appear to be relatively unhealthy and unsustainable, rendering them vulnerable to elevated risk of ill-health. Nevertheless, their dietary patterns did not strongly differ from HG, which may contribute to Hungarians being one of the most obese and malnourished nations in Europe. Further prospective research on the potential public and environmental health effects of these findings is warranted.

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Racism, Not Race, Drives Inequity Across the COVID-19 Continuum

Cited by 189 publications

References 8 publications

Favorable outcome of COVID‐19 among African American (AA) renal transplant recipients in Detroit

Favorable outcome of COVID‐19 among African American (AA) renal transplant recipients in Detroit

COVID-19 in patients with systemic lupus erythematosus: lessons learned from the inflammatory disease

Deteriorated Dietary Patterns with Regards to Health and Environmental Sustainability among Hungarian Roma Are Not Differentiated from Those of the General Population

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