Ethnic disparities in clinical severity of COVID-19 as predictor of long COVID

Abstract

Abstract Background Recent studies from Europe have shown a higher incidence of long COVID among ethnic minorities compared to the majority population. Little is known of these disparities, but they might be related to factors such as COVID-19 disease severity, barriers in access to health and individual factors such as working and living conditions. This study will elucidate possible predictors of long COVID related to COVID-19 disease severity in an ethnic diverse hospitalised cohort. Methods A retrospective cohort study of 1648 patients admitted with COVID-19 at three hospitals in Copenhagen, Denmark, between 1st February 2020 and 31st May 2022. Clinical data was extracted from health care records, and subsequently linked to data from Statistics Denmark on long COVID diagnosis (ICD-10 “DB948A”) as well as migration status. Results 1361 patients were discharged alive and of those, 113 (8,3%) patients got a long COVID diagnosis. Preliminary analyses show no excess risk of getting a long COVID diagnosis as a migrant compared to patients of Danish origin (RR = 1,20, p = 0,35). Some ethnic disparities are seen in disease severity among all patients discharged alive. Patients with migrant background were admitted to the hospital later (6,8 vs 5,6 days, p < 0,0001), and at a greater risk of needing high flow oxygen administration upon admission (RR = 1,46, p = 0,0012) compared to patients of Danish origin. Furthermore, a higher degree of systemic inflammation is seen among migrants with regards to lactate dehydrogenase (LDH) compared to patients of Danish origin (349,7 vs 317,2 U/L, p = 0,0014). No significant differences in c-reactive protein (CRP) levels (92,8 vs 85,9 mg/L, p = 0,11). Conclusions Preliminary analyses indicates possible ethnic disparities in COVID-19 disease severity among patients discharged alive possibly playing a role as predictors of long COVID. Low health literacy or language barriers might partly explain this. Further analyses are needed. Key messages • In preliminary analyses of 1381 patients previously admitted with COVID-19, we find no excess risk of a long COVID diagnosis (DB 948B) among patients with migrant background. • Preliminary analyses show some ethnic disparities in COVID-19 disease severity that might act as possible predictors of long COVID.