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Racial and ethnic disparities in cardiometabolic disease and COVID-19 outcomes in White, Black/African American, and Latinx populations: Physiological underpinnings

Journal

PROGRESS IN CARDIOVASCULAR DISEASES
Volume 71, Issue -, Pages 11-19

Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.pcad.2022.04.005

Keywords

SARS-CoV-2; Cardiovascular disease; Metabolic disease; Health disparities; Obesity

Funding

  1. National Institutes of Health [K01 HL147998, T32 HL139451]

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COVID-19 has disproportionately affected non-Hispanic Black and Hispanic/Latinx populations, leading to higher rates of hospitalization and mortality. These racial and ethnic minority groups also face a greater risk of non-COVID-19-related mortality during the pandemic, which may be attributed to racial disparities in the prevalence of cardiovascular disease (CVD) and metabolic diseases.
Coronavirus disease 2019 (COVID-19) is a highly contagious respiratory illness caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that began spreading globally in late 2019. While most cases of COVID-19 present with mild to moderate symptoms, COVID-19 was the third leading cause of mortality in the United States in 2020 and 2021. Though COVID-19 affects individuals of all races and ethnicities, non-Hispanic Black and Hispanic/Latinx populations are facing an inequitable burden of COVID-19 characterized by an increased risk for hospitalization and mortality. Importantly, non-Hispanic Black and Hispanic/Latinx adults have also faced a greater risk of non-COVID-19-related mortality (e.g., from cardiovascular disease/CVD) during the pandemic. Contributors to the racial disparities in morbidity and mortality during the pandemic are multi factorial as we discuss in our companion article on social determinants of health. However, profound racial variation in the prevalence of CVD and metabolic diseases may serve as a key driver of worse COVID-19-related and non-COVID-19-related health outcomes among racial and ethnic minority groups. Within this review, we provide data emphasizing the inequitable burden of CVD and metabolic diseases among non-Hispanic Black and Hispanic/Latinx populations. We also discuss the pathophysiology of these conditions, with a focus on how aberrant physiological alterations in the context of CVD and metabolic diseases manifest to increase susceptibility to severe COVID-19.(c) 2022 Elsevier Inc. All rights reserved.

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Summary: Racial and ethnic-related health disparities in the United States have been exacerbated by the COVID-19 pandemic, with minority populations at higher risk for severe illness and death. Social determinants of health play a critical role in explaining these disparities among non-Hispanic Black and Hispanic/Latinx individuals compared to non-Hispanic White individuals.

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