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Background Migrants and ethnic minorities have suffered a disproportionate impact of the COVID-19 pandemic compared to the general population from different perspectives. Our aim was to assess specifically their risk of infection in the 53 countries belonging to the World Health Organization European Region, during the first year of the pandemic. Methods We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO CRD42021247326). We searched multiple databases for peer-reviewed literature, published on Medline, Embase, Scisearch, Biosis and Esbiobase in 2020 and preprints from PubMed up to 29/03/2021. We included cross-sectional, case-control, cohort, intervention, case-series, prevalence or ecological studies, reporting the risk of SARS-CoV-2 infection among migrants, refugees, and ethnic minorities. Results Among the 1905 records screened, 25 met our inclusion criteria and were included in the final analysis. We found that migrants and ethnic minorities during the first wave of the pandemic were at increased exposure and risk of infection and were disproportionately represented among COVID-19 cases. However, the impact of COVID-19 on minorities does not seem homogeneous, since some ethnic groups seem to be more at risk than others. Risk factors include high-risk occupations, overcrowded accommodations, geographic distribution, social deprivation, barriers to access to information concerning preventive measures (due to the language barrier or to their marginality), together with biological and genetic susceptibilities. Conclusions Although mixed methods studies will be required to fully understand the complex interplay between the various biological, social, and cultural factors underlying these findings, the impact of structural determinants of health is evident. Our findings corroborate the need to collect migration and ethnicity-disaggregated data and contribute to advocacy for inclusive policies and programmatic actions tailored to reach migrants and ethnic minorities.

The Covid-19 pandemic has had a major impact on migrants and ethnic minorities (MEMs). Socio-economic factors and legal, administrative and language barriers are among the reasons for this increased susceptibility. The aim of the study is to investigate the impact of Covid-19 on MEMs compared to the general population in terms of serious outcomes. We conducted a systematic review collecting studies on the impact of Covid-19 on MEMs compared to the general population in the WHO European Region regarding hospitalisation, intensive care unit (ICU) admission and mortality, published between 01/01/2020 and 19/03/2021. Nine researchers were involved in selection, study quality assessment and data extraction. Of the 82 studies included, 15 of the 16 regarding hospitalisation for Covid-19 reported an increased risk for MEMs compared to the white and/or native population and 22 out of the 28 studies focusing on the ICU admission rates found an increased risk for MEMs. Among the 65 studies on mortality, 43 report a higher risk for MEMs. An increased risk of adverse outcomes was reported for MEMs. Social determinants of health are among the main factors involved in the genesis of health inequalities: a disadvantaged socio-economic status, a framework of structural racism and asymmetric access to healthcare are linked to increased susceptibility to the consequences of Covid-19. These findings underline the need for policymakers to consider the socio-economic barriers when designing prevention plans.

Background: Studying the scientific literature about COVID-19 and Italy, one of the first countries to be hit by the pandemic, allows an investigation into how knowledge develops during a public health emergency.Methods: A systematic review of the literature was conducted to identify articles published on the topic between January and April 2020. Articles were classified according to type of study. Co-occurrence of terms, and geographic and temporal trends were analyzed.Results: Of the 238 articles included in the systematic review, the majority (37%) focused on hospital and clinical management of COVID-19, while 23.9% were commentaries. Epidemiological studies constituted 45.5% of the articles published by authors with non-Italian affiliations.Conclusion: The scientific articles on COVID-19 in Italy were varied in type of study, though with limited international impact. The lockdown and the pressure placed on hospitals during the first wave of the pandemic mainly resulted in publications on disease management and commentaries.

The adoption of digital contact-tracing apps to limit the spread of SARS-CoV-2 has been sup-optimal, but studies that clearly identify factors associated with the app uptake are still limited. In April 2021, we administered a questionnaire to healthcare university students to investigate their attitudes towards and experiences of the IMMUNI app. A multivariable logistic regression model was built to identify app download predictors. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. We surveyed 247 students. Most respondents (65.6%) had not downloaded IMMUNI, reporting as the main reason the perceived app uselessness (32.7%). In the multivariable analysis, being advised to use the app (aOR: 3.21, 95%CI: 1.80–5.73), greater fear of infecting others (aOR: 1.50, 95%CI: 1.01–2.23), and greater trust in the institutional response to the emergency (aOR: 1.33, 95%CI: 1.00–1.76) were positively associated with the outcome, whereas greater belief in the “lab-leak theory” of COVID-19 was a negative predictor (aOR: 0.75, 95%CI: 0.60–0.93). Major technical issues were reported by app users. Targeted strategies aimed at improving awareness of digital health applications should be devised. Furthermore, institutions should invest in the development of these technologies, to minimize technical issues and make them accessible to the entire population.