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. 2024 May 21;14(1):11556.
doi: 10.1038/s41598-024-61097-0.

Racial and ethnic disparities post-hospitalization for COVID-19: barriers to access to care for survivors of COVID-19 acute respiratory distress syndrome

Alicia Cañas  1 , Allison Wolf  2 , Angela Mak  3 , Jacob Ruddy  1 , Sal El-Sadek  4 , Laura Gomez  4 , David Furfaro  5 , Robert Fullilove  6 , Kristin M Burkart  2 , Jennifer Zelnick #  7 , Max R O'Donnell #  8
Affiliations

Racial and ethnic disparities post-hospitalization for COVID-19: barriers to access to care for survivors of COVID-19 acute respiratory distress syndrome

Alicia Cañas et al. Sci Rep. .

Abstract

Racial and ethnic health disparities in the incidence and severity of Coronavirus Disease 2019 (COVID-19) have been observed globally and in the United States. Research has focused on transmission, hospitalization, and mortality among racial and ethnic minorities, but Long COVID-19 health disparities research is limited. This study retrospectively evaluated 195 adults who survived COVID-19 associated acute respiratory distress syndrome (C-ARDS) in New York City from March-April 2020. Among survivors, 54% met the criteria for Long COVID syndrome. Hispanic/Latinx patients, were more likely to be uninsured (p = 0.027) and were less frequently discharged to rehabilitation facilities (p < 0.001). A cross-sectional telephone survey and interview were conducted with a subset of survivors (n = 69). Among these, 11% reported a lack of follow-up primary care post-discharge and 38% had subsequent emergency room visits. Notably, 38% reported poor treatment within the health care system, with 67% attributing this to racial or ethnic bias. Thematic analysis of interviews identified four perceived challenges: decline in functional status, discrimination during hospitalization, healthcare system inequities, and non-healthcare-related structural barriers. Sources of resilience included survivorship, faith, and family support. This study highlights structural and healthcare-related barriers rooted in perceived racism and poverty as factors impacting post-COVID-19 care.

Keywords: ARDS; Access to care; COVID-19; Long COVID; Racial and ethnic disparities.

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Conflict of interest statement

The authors declare no competing interests.

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Figure 1
Study flow diagram.
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