Migrant status, ethnicity and COVID-19: more accurate European data are greatly needed

Melchior, Maria; Loû, Annabel Desgrées du; Gosselin, Anne; Datta, Geetanjali D.; Carabalí, Mabel; Merckx, Joanna; Kaufman, Jay S.

doi:10.1016/j.cmi.2020.10.014

Cited by 17 publications

(17 citation statements)

References 5 publications

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“…Access to high-quality health care might partially explain why case-fatality risk is increased in some settings but not in others. Our results are in line with previous studies reporting an increased infection rate for COVID-19 in different ethnic minorities in different healthcare systems and varying epidemic circumstances [ 1 ]. It is noteworthy that our results come from a setting where access to COVID-19 testing and high-level public health care at low or no cost were technically equal in the population.…”

Section: Discussionsupporting

confidence: 93%

“…This study did not provide data about the mechanisms underlying the increased susceptibility to COVID-19 in language minorities. Possible risk factors may include more crowded housing, larger family sizes, professional exposure, use of public transport, and lack of possibilities for teleworking [ 1 ]. The motivation for testing and adherence to isolation and quarantine recommendations might also be affected by access to social benefits, employment status and ability to understand instructions given in a foreign language, and even attitudes within the given group.…”

Section: Discussionmentioning

confidence: 99%

“…Migrants and ethnic minority populations seem to experience a disproportionate burden of the coronavirus disease 2019 (COVID-19) pandemic [ 1 ]. Higher incidences have been reported in varying ethnic minorities in several countries, but regarding the outcomes the results have been conflicting [ [2] , [3] , [4] , [5] , [6] , [7] , [8] ].…”

Section: Introductionmentioning

confidence: 99%

“…Higher incidences have been reported in varying ethnic minorities in several countries, but regarding the outcomes the results have been conflicting [ [2] , [3] , [4] , [5] , [6] , [7] , [8] ]. Differences in health status, access to health care, housing conditions, family size, professional exposure, use of public transportation, the possibility of teleworking, and economic status have all been identified as factors contributing to increased exposure [ 1 ]. Ethnicity can be defined using various indicators such as the country of birth, nationality, migrant status, race, and self-definition.…”

Section: Introductionmentioning

confidence: 99%

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Association between first language and SARS-CoV-2 infection rates, hospitalization, intensive care admissions and death in Finland: a population-based observational cohort study

Holmberg

Salmi

Kattainen

et al. 2022

Clinical Microbiology and Infection

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Objectives Motivated by reports of increased risk of coronavirus disease 2019 (COVID-19) in ethnic minorities of high-income countries, we explored whether patients with a foreign first language are at an increased risk of COVID-19 infections, more serious presentations, or worse outcomes. Methods In a retrospective observational population-based quality registry study covering a population of 1.7 million, we studied the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), admissions to specialist healthcare and the intensive care unit (ICU), and all-cause case fatality in different language groups between 27th February and 3rd August 2020 in Southern Finland. A first language other than Finnish, Swedish or Sámi served as a surrogate marker for a foreign ethnic background. Results In total, 124 240 individuals were tested, and among the 118 300 (95%) whose first language could be determined, 4005 (3.4%) were COVID-19-positive, 623 (0.5%) were admitted to specialized hospitals, and 147 (0.1%) were admitted to the ICU; 254 (0.2%) died. Those with a foreign first language had lower testing rates (348, 95%CI 340–355 versus 758, 95%CI 753–762 per 10 000, p < 0.0001), higher incidence (36, 95%CI 33–38 versus 22, 95%CI 21–23 per 10 000, p < 0.0001), and higher positivity rates (103, 95%CI 96–109 versus 29, 95%CI 28–30 per 1000, p < 0.0001). There was no significant difference in ICU admissions, disease severity at ICU admission, or ICU outcomes. Case fatality by 90 days was 7.7% in domestic cases and 1.2% in those with a foreign first language, explained by demographics (age- and sex-adjusted HR 0.49, 95%CI 0.21–1.15). Conclusions The population with a foreign first language was at an increased risk for testing positive for SARS-CoV-2, but when hospitalized they had outcomes similar to those in the native, domestic language population. This suggests that special attention should be paid to the prevention and control of infectious diseases among language minorities.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Association between first language and SARS-CoV-2 infection rates, hospitalization, intensive care admissions and death in Finland: a population-based observational cohort study

Holmberg

Salmi

Kattainen

et al. 2022

Clinical Microbiology and Infection

View full text Add to dashboard Cite

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“…However, further research indicated that the relationship between COVID-19 disease severity and race may be more related to higher rates of comorbidities in minority populations and the complex structural disparities among immigrant and minority populations. More specific proposed theories include disparities in access to diagnostics, unbiased health care, safe housing, and essential frontline employment which disproportionately affect minority communities [ 76 , 77 ]. A large urban medical center in the USA found that of more than 9000 screened adults, Hispanic (65.3%) and non-Hispanic Black (68.5%) adults were more likely than non-Hispanic white (53.0%) adults to test positive for SARS-CoV2 ( p value < 0.001) [ 78 ].…”

Section: Sars-cov2 Infection In Special Pediatric Nephrology Populationsmentioning

confidence: 99%

Kidney implications of SARS-CoV2 infection in children

et al. 2021

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Research indicates that severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection can impact every organ, and the effects can range from asymptomatic to severe disease. Since it was first discovered in December 2019, our understanding has grown about its impact on kidney disease. In general, children have less severe disease than adults, and this tendency appears to extend to special pediatric kidney populations (e.g., chronic kidney disease and immunosuppressed patients with solid organ transplants or nephrotic syndrome). However, in a fraction of infected children, SARS-CoV2 causes an array of kidney manifestations, ranging from acute kidney injury to thrombotic microangiopathy, with potential implications for increased risk of morbidity and mortality. Additional considerations surround the propensity for clotting extracorporeal circuits in children with SARS-CoV2 infection that are receiving kidney replacement therapy. This review provides an update on our current understanding of SARS-CoV2 for pediatric nephrologists and highlights knowledge gaps to be addressed by future research during this ongoing pandemic, particularly the social disparities magnified during this period.

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Preferences for Alternative Care Modalities Among French Adults With Chronic Illness

et al. 2021

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IMPORTANCEThe COVID-19 pandemic led to the implementation of alternative care modalities (eg, teleconsultations and task shifting) that will continue to be implemented in parallel to traditional care after the pandemic. An ideal balance between alternative and traditional care modalities is unknown.OBJECTIVES To quantify the ideal postpandemic balance between alternative and traditional care modalities among patients with chronic illness and to qualify the circumstances in which patients consider it appropriate to replace traditional care with alternative care. DESIGN, SETTING, AND PARTICIPANTSThis survey study invited 5999 adults with chronic illness in ComPaRe, a French nationwide e-cohort of adults with chronic conditions who volunteer their time to participate in research projects, to participate in this study, which was performed from January 27 to February 23, 2021. MAIN OUTCOMES AND MEASURESParticipants rated the ideal proportion at which they would use 3 alternative care modalities instead of the traditional care equivalent on a 0% to 100% scale (with 0% indicating using alternative care modalities for none of one's future care and 100% indicating using alternative care modalities for all of one's future care) of their overall future care: (1) teleconsultations, (2) online symptom-checkers to react to new symptoms, and (3) remote monitoring to adapt treatment outside consultations. The median ideal proportion of alternative care use was calculated. Perceived appropriate circumstances in which each alternative modality could replace traditional care were collected with open-ended questions. Analyses were performed on a weighted data set representative of patients with chronic illness in France. RESULTS Of the 5999 invited individuals, 1529 (mean [SD] age, 50.3 [14.7] years; 1072 [70.1%]female) agreed to participate (participation rate, 25.5%). Participants would choose teleconsultations for 50.0% of their future consultations (IQR, 11.0%-52.0%), online symptomcheckers over contacting their physician for 22.0% of new symptoms (IQR, 2.0%-50.0%), and remote monitoring instead of consultations for 52.3% of their treatment adaptations (IQR, 25.4%-85.4%). Participants reported 67 circumstances for which replacing traditional with alternative care modalities was considered appropriate, including 31 care activities (eg, prescription renewal and addressing acute or minor complaints), 25 patient characteristics (eg, stable chronic condition and established patient-physician relationship), and 11 required characteristics of the alternative care modalities (eg, quality assurance). CONCLUSIONS AND RELEVANCEResults of this survey study suggest that after the pandemic, patients would choose alternative over traditional care for 22% to 52% of the time across different care needs. Participants proposed 67 criteria to guide clinicians in replacing traditional care with (continued) Key Points Question What is an ideal balance between alternative care modalities implemented during the COVID-19 pandemic and traditional care in...

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Migrant status, ethnicity and COVID-19: more accurate European data are greatly needed

Cited by 17 publications

References 5 publications

Association between first language and SARS-CoV-2 infection rates, hospitalization, intensive care admissions and death in Finland: a population-based observational cohort study

Association between first language and SARS-CoV-2 infection rates, hospitalization, intensive care admissions and death in Finland: a population-based observational cohort study

Kidney implications of SARS-CoV2 infection in children

Preferences for Alternative Care Modalities Among French Adults With Chronic Illness

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