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Multicenter Study
. 2024 Jan 30:11:1324636.
doi: 10.3389/fpubh.2023.1324636. eCollection 2023.

Ethnic and racial differences in self-reported symptoms, health status, activity level, and missed work at 3 and 6 months following SARS-CoV-2 infection

Kelli N O'Laughlin #  1   2 , Robin E Klabbers #  1   2 , Imtiaz Ebna Mannan  3 , Nicole L Gentile  4   5   6 , Rachel E Geyer  4 , Zihan Zheng  4 , Huihui Yu  3   7 , Shu-Xia Li  3 , Kwun C G Chan  8   9 , Erica S Spatz  7   10   11 , Ralph C Wang  12 , Michelle L'Hommedieu  13 , Robert A Weinstein  14   15 , Ian D Plumb  16 , Michael Gottlieb  17 , Ryan M Huebinger  18 , Melissa Hagen  16 , Joann G Elmore  13 , Mandy J Hill  18 , Morgan Kelly  19 , Samuel McDonald  20   21 , Kristin L Rising  19   22 , Robert M Rodriguez  12 , Arjun Venkatesh  3   23 , Ahamed H Idris  20 , Michelle Santangelo  14 , Katherine Koo  14 , Sharon Saydah  16 , Graham Nichol #  1 , Kari A Stephens #  4   24 ; INSPIRE Group
Affiliations
Multicenter Study

Ethnic and racial differences in self-reported symptoms, health status, activity level, and missed work at 3 and 6 months following SARS-CoV-2 infection

Kelli N O'Laughlin et al. Front Public Health. .

Abstract

Introduction: Data on ethnic and racial differences in symptoms and health-related impacts following SARS-CoV-2 infection are limited. We aimed to estimate the ethnic and racial differences in symptoms and health-related impacts 3 and 6 months after the first SARS-CoV-2 infection.

Methods: Participants included adults with SARS-CoV-2 infection enrolled in a prospective multicenter US study between 12/11/2020 and 7/4/2022 as the primary cohort of interest, as well as a SARS-CoV-2-negative cohort to account for non-SARS-CoV-2-infection impacts, who completed enrollment and 3-month surveys (N = 3,161; 2,402 SARS-CoV-2-positive, 759 SARS-CoV-2-negative). Marginal odds ratios were estimated using GEE logistic regression for individual symptoms, health status, activity level, and missed work 3 and 6 months after COVID-19 illness, comparing each ethnicity or race to the referent group (non-Hispanic or white), adjusting for demographic factors, social determinants of health, substance use, pre-existing health conditions, SARS-CoV-2 infection status, COVID-19 vaccination status, and survey time point, with interactions between ethnicity or race and time point, ethnicity or race and SARS-CoV-2 infection status, and SARS-CoV-2 infection status and time point.

Results: Following SARS-CoV-2 infection, the majority of symptoms were similar over time between ethnic and racial groups. At 3 months, Hispanic participants were more likely than non-Hispanic participants to report fair/poor health (OR: 1.94; 95%CI: 1.36-2.78) and reduced activity (somewhat less, OR: 1.47; 95%CI: 1.06-2.02; much less, OR: 2.23; 95%CI: 1.38-3.61). At 6 months, differences by ethnicity were not present. At 3 months, Other/Multiple race participants were more likely than white participants to report fair/poor health (OR: 1.90; 95% CI: 1.25-2.88), reduced activity (somewhat less, OR: 1.72; 95%CI: 1.21-2.46; much less, OR: 2.08; 95%CI: 1.18-3.65). At 6 months, Asian participants were more likely than white participants to report fair/poor health (OR: 1.88; 95%CI: 1.13-3.12); Black participants reported more missed work (OR, 2.83; 95%CI: 1.60-5.00); and Other/Multiple race participants reported more fair/poor health (OR: 1.83; 95%CI: 1.10-3.05), reduced activity (somewhat less, OR: 1.60; 95%CI: 1.02-2.51; much less, OR: 2.49; 95%CI: 1.40-4.44), and more missed work (OR: 2.25; 95%CI: 1.27-3.98).

Discussion: Awareness of ethnic and racial differences in outcomes following SARS-CoV-2 infection may inform clinical and public health efforts to advance health equity in long-term outcomes.

Keywords: COVID-19; SARS-CoV-2; cohort; disparities; ethnicity; race; survey.

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Conflict of interest statement

JGE is Editor in Chief of Adult Primary Care topics for UpToDate. MG reports grant funding from the Rush Center for Emerging Infectious Diseases Research Grant, Biomedical Advanced Research and Development Authority Research Grant, Emergency Medicine Foundation/Council of Residency Directors in Emergency Medicine Education Research Grant, Emergency Medicine: Reviews and Perspectives Medical Education Research Grant, University of Ottawa Department of Medicine Education Grant; and Society of Directors of Research in Medical Education Grant. KLR reports research grant funding from Abbott Diagnostics, DermTech, MeMed, Prenosis, and Siemens Healthcare Diagnostics. RMR reports research funding for PROCOVAXED funded by NIAID R01AI166967-01 (PI: Rodriquez). KK reports HECAP funded by RWJF (contract number: 79308 PI: Ansell); Chicago Department of Public Health Order 2020–4 COVID-19 Data Sharing for Patient Safety and Capacity Management funded by CDC (contract number: 6NU50CK000556-01-04 PI: Saldanha). GN reports funding through National Institutes of Health. PROCOVAXED Trial, Site PI. Centers for Disease Control and Prevention. Clinical Core, INSPIRE Registry, PI. Patient-Centered Outcomes Research Institute, Washington, DC. University of Washington PCORNet Expansion Award, Joint PI. Abiomed Inc., Danvers, MA. Emergency Care Core for Trial of Impella in Patients with STEMI and Cardiogenic Shock (RECOVER IV), PI. ZOLL Medical Corp., Chelmsford, MA, Multidimensional Study of Oxygenation in Early Post-Resuscitation (MOSER), PI. Vapotherm Inc., Exeter, NH. Vapotherm Device for Rapid Cooling Study (VOS), Co-PI. ZOLL Circulation Inc., San Jose, CA. Better Resuscitation with Supersaturated Oxygen (BASSO) Study, Co-PI. Powerful Medical Inc., Bratislava, Slovakia, US Validation Study of AI-Enhanced Diagnosis of Occluding Myocardial Infarction, PI. CPR Therapeutics Inc., Putney, VT. Consultant. Heartbeam Inc., Santa Clara, CA. Consultant. Invero Health LLC, Montville, NJ. Consultant. Kestra Medical Technologies Inc., Kirkland, WA. Consultant. Orixha Inc., Saint Cyr Au Mont d’Or, France. Consultant. BrainCool AB, Lund, Sweden. Consultant Patent for measurement of blood flow during CPR; non-provisional patent pending for blood flow measurement during CPR using signal gating; non-provisional patent pending for reperfusion-injury modifying device; all assigned to University of Washington. KNO reports research grant funding for PROCOVOXED funded by NIAID R01 AI166967 (PI: Rodriguez). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
INSPIRE participant flow diagram.
Figure 2
Figure 2
Forest plots to demonstrate study outcomes by ethnicity and race using adjusted analyses among adult SARS-CoV-2-positive INSPIRE participants.
See this image and copyright information in PMC

References

    1. Wingrove-Haugland E, McLeod J. Not minority but minoritized. Teach Ethics. (2021) 21:1–11. doi: 10.5840/tej20221799 - DOI
    1. Black C, Cerdeña JP, Spearman-McCarthy EV. I am not your minority. Lancet Reg Health Am. (2023) 19:100464. doi: 10.1016/j.lana.2023.100464, PMID: - DOI - PMC - PubMed
    1. Stringer SM. New York City’s frontline workers. Report Bureau of Policy and Research. (2020) Available at: https://comptroller.nyc.gov/reports/new-york-citys-frontline-workers/
    1. Dubay L, Aarons J, Brown KS, Kenney GM: How risk of exposure to the coronavirus at work varies by race and ethnicity and how to protect the health and well-being of workers and their families. (2020). Available at: https://www.urban.org/sites/default/files/publication/103278/how-risk-of...
    1. Khanijahani A, Iezadi S, Gholipour K, Azami-Aghdash S, Naghibi D. A systematic review of racial/ethnic and socioeconomic disparities in COVID-19. Int J Equity Health. (2021) 20:248. doi: 10.1186/s12939-021-01582-4, PMID: - DOI - PMC - PubMed

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