Risk Factors for COVID-19 Positivity and Hospital Admission Among Arab American Adults in Southern California

Abstract

Objective: Little is known about risk factors associated with COVID-19 infection among Arab American people. We aimed to understand the predictors of receiving a positive COVID-19 test result and being admitted to the hospital for COVID-19 among Arab American adults using data from a hospital near an Arab ethnic enclave. Methods: We used electronic medical record data for Arab American adults aged ≥18 years from March 1, 2020, through January 31, 2021, at Sharp Grossmont Hospital in La Mesa, California. The primary outcomes were receiving a positive COVID-19 test result and being admitted to the hospital for COVID-19. We ran logistic regression models with individual- and population-level risk factors to determine the odds of each primary outcome. Results: A total of 2744 Arab American adults were tested for COVID-19, of whom 783 (28.5%) had a positive test result. In the fully adjusted model, women had lower odds of receiving a positive test result than men (adjusted odds ratio [aOR] = 0.77; 95% CI, 0.64-0.92), and adults living in high-poverty areas had higher odds of receiving a positive test result than adults in lower-poverty areas (aOR = 1.25; 95% CI, 1.04-1.51). Of the 783 Arab American adults with data on admission, 131 (16.7%) were admitted. For every 1-unit increase in the Charlson Comorbidity Index, the odds of admission increased by 66% (aOR = 1.66; 95% CI, 1.36-2.04). Conclusion: The risk of receiving a positive test result for COVID-19 was higher among Arab American adults living in high-poverty areas than in lower-poverty areas. The risk of admission was directly related to overall health status. Future work should aim to understand the barriers to prevention and testing in this population.

Risk factors for SARS-CoV-2 infection during the early stages of the COVID-19 pandemic: a systematic literature review

“…It is important to better understand the links between different risk factors and the behaviors that drive them so targeted responses and interventions can be designed. This relationship between risk factors was also observed in the most commonly reported risk factors, minority ethnicity or race and country of birth ( 18 , 28 , 30 , 31 , 36 , 37 , 41 , 43 , 46 ). As previously highlighted, one study found that speaking a language other than English in the household, was an indicator of increased risk of infection ( 41 ).…”

“…The ethnic minority groups which were reviewed varied considerably between studies, due to the different regions each study was conducted in. Studies from the USA commonly explored Hawaiian/Pacific Island, Hispanic or Latinx communities ( 30 , 31 , 36 , 37 , 41 , 43 ) where conversely, studies conducted through Europe, would investigate other European nations or African regions ( 21 , 28 , 46 ). One study also reviewed the use of non-English language in the family/home and found that the use of non-English language increased infection risk ( 41 ).…”