对研究COVID-19相关死亡的综合性方法:使用英国生物库数据的队列研究
Daniela Fonseca de Freitas1,2,3, Kamaldeep Bhui1,4,5, Christophe Clesse6,7
1CHiMES Collaborative, Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK.
Journal of public health (Oxford, England)
|December 16, 2024
概括
社会和经济上的不便,加上不健康的行为,显著增加了多种长期疾病 (MLTC) 的风险,这反过来又提高了COVID-19死亡风险. 解决社会决定因素和多病症至关重要.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康的社会决定因素
背景情况:
- COVID-19大流行不成比例地影响了较低社会经济条件的个人,突出了感染,严重程度和死亡率的差异.
- 综合症理论为了解社会逆境和多种长期疾病 (MLTC) 在加剧COVID-19等健康危机中的相互作用提供了一个框架.
研究的目的:
- 通过综合症理论研究社会逆境和MLTC对COVID-19死亡率的影响.
- 阐明连接创伤事件,经济贫困,不健康行为和MLTC与COVID-19死亡率的途径.
主要方法:
- 对英国生物库参与者的分析 (n=154,725).
- 利用结构方程建模来探索因果路径.
- 采用考克斯回归分析来评估MLTC和COVID-19死亡率,并进行效果修改测试.
主要成果:
- MLTC直接解释了COVID-19的死亡率.
- 经济贫困和不健康的行为通过恶化MLTC间接导致COVID-19死亡.
- 随着预测的MLTC得分更高,COVID-19死亡风险呈指数级增加.
- 创伤性事件,经济贫困或不健康的行为并没有改变MLTC死亡率关系.
结论:
- 一个连续的途径存在,经济贫困和不健康的行为导致MLTC,显著增加COVID-19死亡风险.
- 政策干预应针对健康的社会决定因素,并减轻多病症的影响,以减少COVID-19死亡率.
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