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. 2025 Sep 4:12:100354.
doi: 10.1016/j.jmh.2025.100354. eCollection 2025.

Health outcomes of COVID-19 in immigrants versus native Spaniards

Jose Manuel Ruiz Giardin  1   2 , Nieves Mesa Plaza  1 , Almudena Escribá Bárcena  3 , Juan Victor SanMartín López  1   2 , Sonia Gonzalo Pascua  1 , Luis Antonio Lechuga Suárez  4 , Santiago Prieto Menchero  5 , Maria Jesús Domínguez García  6 , Sergio Serrano Villar  2   7 , Santiago Moreno Guillén  2   7   8 ; on behalf FUENCOVID group
Affiliations

Health outcomes of COVID-19 in immigrants versus native Spaniards

Jose Manuel Ruiz Giardin et al. J Migr Health. .

Abstract

Background: During the SARS-CoV-2 pandemic, the differential impact on ethnic groups has been widely debated. This study examines the immigrant population of Fuenlabrada, Spain, analyzing their infection, hospitalization, ICU admission, and mortality rates compared with the Spanish population.

Methods: This ambispective observational study (March 2020-January 2023) analyzed infection rates, hospitalizations, ICU admissions, and deaths among 215,000 inhabitants (10 % immigrants). Propensity score analysis was conducted to ensure comparability between groups.

Findings: Among 14,688 patients with 18,724 infections, 4102 (21·9 %) infections occurred in immigrants. Of 5429 hospitalized infections, 989 (19·2 %) involved immigrants. Immigrants had more than double the hospitalization rates of Spaniards (fourfold among Latin Americans). Spaniards were older (by 16 years), had higher comorbidities, longer hospital stays, and higher one-month mortality (4·9 % vs. 1 %). Vaccination rates were lower among immigrants (Spaniards 77 %, Latin Americans 70 %, other immigrants ∼50 %). Adjusted analyses revealed no significant differences in mortality between groups.

Interpretation: Elevated infection rates in immigrants, particularly Latin Americans, likely explain their higher hospitalization and ICU admission rates. Mortality, adjusted for demographics and clinical factors, did not differ significantly. Future research should explore the socio-demographic and genetic contributors to these disparities.

Keywords: COVID-19; Death; Ethnic groups; Hospitalization; Infections; SARS-CoV-2.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The author is an Editorial Board Member/Editor-in-Chief/Associate Editor/Guest Editor for this journal and was not involved in the editorial review or the decision to publish this article. There are not financial interests/personal relationships wich may be considered as potential competing interests.

Figures

Fig 1
Fig. 1
Hospital visists: Rates per 1000 inhabitants and percentages (readmissions not considered).
Fig 2
Fig. 2
Hospitalization rates per 1000 inhabitants by origin and epidemic waves.
Fig 3
Fig. 3
ICU admissions Rates by 10.000 inhabitants and epidemic waves.
Fig 4
Fig. 4
Unadjusted Cox regression of time to death at February 2024.
Fig 5
Fig. 5
Cox regression (adjusted) of time to death at February 2024.
None
See this image and copyright information in PMC

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