PDF(Pubmed)
Abstract：
BACKGROUND: Ethnic minorities living in high-income countries have been disproportionately affected by Coronavirus Disease 2019 (COVID-19) in terms of infection rates, hospitalisations, and deaths; however, less is known about long COVID in these populations. Our aim was to examine the risk of long COVID and associated symptoms among ethnic minorities.
RESULTS: We used nationwide register-based cohort data on individuals diagnosed with COVID-19 aged ≥18 years (n = 2,287,175) between January 2020 and August 2022 in Denmark. We calculated the risk of long COVID diagnosis and long COVID symptoms among ethnic minorities compared with native Danes using multivariable Cox proportional hazard regression and logistic regression, respectively. Among individuals who were first time diagnosed with COVID-19 during the study period, 39,876 (1.7%) were hospitalised and 2,247,299 (98.3%) were nonhospitalised individuals. Of the diagnosed COVID-19 cases, 1,952,021 (85.3%) were native Danes and 335,154 (14.7%) were ethnic minorities. After adjustment for age, sex, civil status, education, family income, and Charlson comorbidity index, ethnic minorities from North Africa (adjusted hazard ratio [aHR] 1.41, 95% confidence interval [CI] [1.12,1.79], p = 0.003), Middle East (aHR 1.38, 95% CI [1.24,1.55], p < 0.001), Eastern Europe (aHR 1.35, 95% CI [1.22,1.49], p < 0.001), and Asia (aHR 1.23, 95% CI [1.09,1.40], p = 0.001) had significantly greater risk of long COVID diagnosis than native Danes. In the analysis by largest countries of origin, the greater risks of long COVID diagnosis were found in people of Iraqi origin (aHR 1.56, 95% CI [1.30,1.88], p < 0.001), people of Turkish origin (aHR 1.42, 95% CI [1.24,1.63], p < 0.001), and people of Somali origin (aHR 1.42, 95% CI [1.07,1.91], p = 0.016). A significant factor associated with an increased risk of long COVID diagnosis was COVID-19 hospitalisation. The risk of long COVID diagnosis among ethnic minorities was more pronounced between January 2020 and June 2021. Furthermore, the odds of reporting cardiopulmonary symptoms (including dyspnoea, cough, and chest pain) and any long COVID symptoms were higher among people of North African, Middle Eastern, Eastern European, and Asian origins than among native Danes in both unadjusted and adjusted models. Despite including the nationwide sample of individuals diagnosed with COVID-19, the precision of our estimates on long COVID was limited to the sample of patients with symptoms who had contacted the hospital.
CONCLUSIONS: Belonging to an ethnic minority group was significantly associated with an increased risk of long COVID, indicating the need to better understand long COVID drivers and address care and treatment strategies in these populations.
RESULTS: We used nationwide register-based cohort data on individuals diagnosed with COVID-19 aged ≥18 years (n = 2,287,175) between January 2020 and August 2022 in Denmark. We calculated the risk of long COVID diagnosis and long COVID symptoms among ethnic minorities compared with native Danes using multivariable Cox proportional hazard regression and logistic regression, respectively. Among individuals who were first time diagnosed with COVID-19 during the study period, 39,876 (1.7%) were hospitalised and 2,247,299 (98.3%) were nonhospitalised individuals. Of the diagnosed COVID-19 cases, 1,952,021 (85.3%) were native Danes and 335,154 (14.7%) were ethnic minorities. After adjustment for age, sex, civil status, education, family income, and Charlson comorbidity index, ethnic minorities from North Africa (adjusted hazard ratio [aHR] 1.41, 95% confidence interval [CI] [1.12,1.79], p = 0.003), Middle East (aHR 1.38, 95% CI [1.24,1.55], p < 0.001), Eastern Europe (aHR 1.35, 95% CI [1.22,1.49], p < 0.001), and Asia (aHR 1.23, 95% CI [1.09,1.40], p = 0.001) had significantly greater risk of long COVID diagnosis than native Danes. In the analysis by largest countries of origin, the greater risks of long COVID diagnosis were found in people of Iraqi origin (aHR 1.56, 95% CI [1.30,1.88], p < 0.001), people of Turkish origin (aHR 1.42, 95% CI [1.24,1.63], p < 0.001), and people of Somali origin (aHR 1.42, 95% CI [1.07,1.91], p = 0.016). A significant factor associated with an increased risk of long COVID diagnosis was COVID-19 hospitalisation. The risk of long COVID diagnosis among ethnic minorities was more pronounced between January 2020 and June 2021. Furthermore, the odds of reporting cardiopulmonary symptoms (including dyspnoea, cough, and chest pain) and any long COVID symptoms were higher among people of North African, Middle Eastern, Eastern European, and Asian origins than among native Danes in both unadjusted and adjusted models. Despite including the nationwide sample of individuals diagnosed with COVID-19, the precision of our estimates on long COVID was limited to the sample of patients with symptoms who had contacted the hospital.
CONCLUSIONS: Belonging to an ethnic minority group was significantly associated with an increased risk of long COVID, indicating the need to better understand long COVID drivers and address care and treatment strategies in these populations.
摘要：
背景：生活在高收入国家的少数民族在感染率方面受到2019年冠状病毒病(COVID-19)的不成比例的影响，住院治疗,和死亡；然而，在这些人群中，人们对长型COVID的了解较少。我们的目的是检查少数族裔人群长期COVID和相关症状的风险。
结果：我们使用了2020年1月至2022年8月在丹麦诊断为年龄≥18岁的COVID-19（n=2,286,955）的全国注册队列数据。我们使用多变量Cox比例风险回归和logistic回归计算了少数民族与本地丹麦人之间长期COVID诊断和长期COVID症状的风险，分别。在研究期间首次诊断为COVID-19的个体中，39,876人（1.7％）住院，2,247,079人（98.3％）为非住院个体。在确诊的COVID-19病例中，1,952,021（85.3％）是本地丹麦人，334,934（14.7％）是少数民族。调整后的年龄，性别,公民身份,教育,家庭收入,和Charlson合并症指数,来自北非的少数民族(调整后的危险比[AHR]1.41，95%置信区间[CI][1.12，1.79]，p=0.003),中东（AHR1.38，95%CI[1.24,1.55]，p<0.001)，东欧（AHR1.35，95%CI[1.22,1.49]，p<0.001)，和亚洲(AHR1.23，95%CI[1.09,1.40]，p=0.001）的长期COVID诊断风险明显高于本地丹麦人。在最大的原籍国的分析中，在伊拉克血统的人群中发现长期COVID诊断的风险更大(aHR1.56，95%CI[1.30,1.88]，p<0.001)，土耳其裔人(AHR1.42，95%CI[1.24,1.63]，p<0.001)，和索马里血统的人(aHR1.42，95%CI[1.07,1.91]，p=0.016)。与长期COVID诊断风险增加相关的一个重要因素是COVID-19住院。在2020年1月至2021年6月期间，少数民族长期诊断COVID的风险更为明显。此外，报告心肺症状(包括呼吸困难，咳嗽,和胸痛)和任何长时间的COVID症状在北非人群中都较高，中东,东欧,在未经调整和调整的模型中，亚洲血统比本土丹麦人都要多。尽管包括全国范围内被诊断为COVID-19的个体样本，但我们对长COVID的估计的准确性仅限于与医院联系的有症状的患者样本。
结论：属于少数民族与长期COVID的风险增加显著相关，这表明需要更好地了解长期COVID驱动因素，并解决这些人群的护理和治疗策略。
结果：我们使用了2020年1月至2022年8月在丹麦诊断为年龄≥18岁的COVID-19（n=2,286,955）的全国注册队列数据。我们使用多变量Cox比例风险回归和logistic回归计算了少数民族与本地丹麦人之间长期COVID诊断和长期COVID症状的风险，分别。在研究期间首次诊断为COVID-19的个体中，39,876人（1.7％）住院，2,247,079人（98.3％）为非住院个体。在确诊的COVID-19病例中，1,952,021（85.3％）是本地丹麦人，334,934（14.7％）是少数民族。调整后的年龄，性别,公民身份,教育,家庭收入,和Charlson合并症指数,来自北非的少数民族(调整后的危险比[AHR]1.41，95%置信区间[CI][1.12，1.79]，p=0.003),中东（AHR1.38，95%CI[1.24,1.55]，p<0.001)，东欧（AHR1.35，95%CI[1.22,1.49]，p<0.001)，和亚洲(AHR1.23，95%CI[1.09,1.40]，p=0.001）的长期COVID诊断风险明显高于本地丹麦人。在最大的原籍国的分析中，在伊拉克血统的人群中发现长期COVID诊断的风险更大(aHR1.56，95%CI[1.30,1.88]，p<0.001)，土耳其裔人(AHR1.42，95%CI[1.24,1.63]，p<0.001)，和索马里血统的人(aHR1.42，95%CI[1.07,1.91]，p=0.016)。与长期COVID诊断风险增加相关的一个重要因素是COVID-19住院。在2020年1月至2021年6月期间，少数民族长期诊断COVID的风险更为明显。此外，报告心肺症状(包括呼吸困难，咳嗽,和胸痛)和任何长时间的COVID症状在北非人群中都较高，中东,东欧,在未经调整和调整的模型中，亚洲血统比本土丹麦人都要多。尽管包括全国范围内被诊断为COVID-19的个体样本，但我们对长COVID的估计的准确性仅限于与医院联系的有症状的患者样本。
结论：属于少数民族与长期COVID的风险增加显著相关，这表明需要更好地了解长期COVID驱动因素，并解决这些人群的护理和治疗策略。
