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. 2022 Feb:13:100284.
doi: 10.1016/j.lanepe.2021.100284. Epub 2021 Dec 14.

Differences in SARS-CoV-2 infections during the first and second wave of SARS-CoV-2 between six ethnic groups in Amsterdam, the Netherlands: A population-based longitudinal serological study

Liza Coyer  1   2 , Anders Boyd  1   3 , Janke Schinkel  4 , Charles Agyemang  5 , Henrike Galenkamp  5 , Anitra D M Koopman  5 , Tjalling Leenstra  1 , Yvonne T H P van Duijnhoven  1 , Eric P Moll van Charante  5   6 , Bert-Jan H van den Born  5   7 , Anja Lok  8 , Arnoud Verhoeff  9   1   10 , Aeilko H Zwinderman  11 , Suzanne Jurriaans  4 , Karien Stronks  5 , Maria Prins  1   2
Affiliations

Differences in SARS-CoV-2 infections during the first and second wave of SARS-CoV-2 between six ethnic groups in Amsterdam, the Netherlands: A population-based longitudinal serological study

Liza Coyer et al. Lancet Reg Health Eur. 2022 Feb.

Abstract

Background: Surveillance data in high-income countries have reported more frequent SARS-CoV-2 diagnoses in ethnic minority groups. We examined the cumulative incidence of SARS-CoV-2 and its determinants in six ethnic groups in Amsterdam, the Netherlands.

Methods: We analysed participants enrolled in the population-based HELIUS cohort, who were tested for SARS-CoV-2-specific antibodies and answered COVID-19-related questions between June 24-October 9, 2020 (after the first wave) and November 23, 2020-March 31, 2021 (during the second wave). We modelled SARS-CoV-2 incidence from January 1, 2020-March 31, 2021 using Markov models adjusted for age and sex. We compared incidence between ethnic groups over time and identified determinants of incident infection within ethnic groups.

Findings: 2,497 participants were tested after the first wave; 2,083 (83·4%) were tested during the second wave. Median age at first visit was 54 years (interquartile range=44-61); 56·6% were female. Compared to Dutch-origin participants (15·9%), cumulative SARS-CoV-2 incidence was higher in participants of South-Asian Surinamese (25·0%; adjusted hazard ratio [aHR]=1·66; 95%CI=1·16-2·40), African Surinamese (28·9%, aHR=1·97; 95%CI=1·37-2·83), Turkish (37·0%; aHR=2·67; 95%CI=1·89-3·78), Moroccan (41·9%; aHR=3·13; 95%CI=2·22-4·42), and Ghanaian (64·6%; aHR=6·00; 95%CI=4·33-8·30) origin. Compared to those of Dutch origin, differences in incidence became wider during the second versus first wave for all ethnic minority groups (all p-values for interaction<0·05), except Ghanaians. Having household members with suspected SARS-CoV-2 infection, larger household size, and low health literacy were common determinants of SARS-CoV-2 incidence across groups.

Interpretation: SARS-CoV-2 incidence was higher in the largest ethnic minority groups of Amsterdam, particularly during the second wave. Prevention measures, including vaccination, should be encouraged in these groups.

Funding: ZonMw, Public Health Service of Amsterdam, Dutch Heart Foundation, European Union, European Fund for the Integration of non-EU immigrants.

Keywords: Antibody; COVID-19; Ethnicity; Incidence; Infection; SARS-CoV-2; Serology.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests related to the project.

Figures

Fig 1
Fig. 1
Flowchart depicting the selection and participation of HELIUS participants in the COVID-19 seroprevalence substudy by migration background, Amsterdam, the Netherlands, June 24, 2020–March 31, 2021.
Fig 2
Fig. 2
Estimated cumulative SARS-CoV-2 incidence between January 1, 2020 and March 31, 2021 per ethnic group, adjusted for age and sex, HELIUS COVID-19 seroprevalence substudy. Footnote: Incidence was based on SARS-CoV-2 antibody test results from two subsequent study visits. The first visit took place between June 24 and October 9, 2020 and the second between November 23, 2020 and March 31, 2021. We modelled the transition of negative to positive SARS-CoV-2 antibody test using a time-homogenous, continuous-time, two-state Markov model, assuming all participants were SARS-CoV-2 negative on January 1, 2020.
Fig 3
Fig. 3
Determinants of SARS-CoV-2 incidence by ethnic group, HELIUS COVID-19 seroprevalence substudy (multivariable analysis). Footnote: Models were fit separately for each ethnic group. Only variables retained in the multivariable model (with P<0·05) are shown (Supplementary Tables S4–9).
See this image and copyright information in PMC

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