Long Covid: risk and symptoms will depend on ethnicity – Science et Avenir

We are not all equal in the face of a protracted Covid. Several factors can increase the risk of developing the long-term effects of Covid, such as age, gender, comorbidities, or lifestyle. American researchers have identified another potential risk factor: ethnicity. According to their research published February 16, 2023. Journal of General Internal Medicine, people of African or Hispanic descent will be at greater risk for most symptoms associated with long-term Covid than people of Caucasian descent. The difference is already observed for the acute phase of Covid-19, when these minorities had a higher risk of hospitalization and death.

African Americans and Hispanics are more at risk

The authors analyzed medical data from the Insight Network, which includes all patients from five major New York City clinical hospitals (Cornell University, Columbia University, New York University, Albert Einstein College, and Mount Sinai Icahn School of Medicine). The study included 62,000 patients who had Covid between March 2020 and October 2021 and compared them with almost 250,000 patients who did not have Covid. Nearly half of Covid patients were Caucasian (47%), compared to 32% Hispanic and 20% African American (about 60% of the cohort were women). The authors then analyzed the risk of developing a new symptom between 30 and 180 days post-infection.

Not surprisingly, Covid patients were at greater risk of developing a large number of symptoms, as has been repeatedly shown. But this risk was largely dependent on ethnicity: people of African descent, even more than Caucasians, were at risk of circulatory diseases, anemia, diabetes and other symptoms. Caucasians were only at greater risk of sleep disturbances, hair loss, fatigue, and encephalopathy. As for Hispanics, they had a higher risk of circulatory and digestive disorders than Caucasians. Faced with this, African Americans thus had a higher risk of post-COVID damage in 4 of the 8 organs studied, 6 of 8 for Hispanics.

Socio-economic conditions are not the only explanation

A potential reason for this increased risk among these minorities may be the socioeconomic level, which largely determines the quality of health monitoring in the United States. But most of these differences persisted even when taking into account the socioeconomic conditions of the patients, so social inequality is not the only explanation. The authors suggest that this observed increase may be partly due to the increased risk these minorities already had in the face of Covid-19, because people with severe Covid are generally more at risk of developing long-term Covid. Inequalities in access to Covid vaccines, which benefit Caucasian communities more than minorities, may also have an impact.

These minorities are less likely to be diagnosed with Covid

On the other hand, the likelihood of having a long-term Covid diagnosis appears to be more dependent on socioeconomic level, and not necessarily in a good way, according to a study also published February 16, 2023 in the journal BMC Medicine. In the United States, a diagnostic code was created specifically for the long-term effects of Covid. The researchers studied the use of this code in the healthcare system across the country: almost 34,000 people had this code in their medical records. Their analysis shows that the majority of people with this diagnosis are Caucasians, women living in areas with low poverty and low unemployment.

This is unlikely to be an accurate reflection of the true long-term Covid population, but rather a reflection of racial and social disparities in access to and quality of care in the United States. Patients from less prosperous areas are less likely to receive this code at a healthcare facility, which may have implications for their subsequent identification as patients with long-term Covid,” the authors regret. But it is possible that this is not only the case in the United States, because such differences in health status have also been noted in France. For example, the department of Seine-Saint-Denis, the first department in France in terms of immigration) also has the fewest private doctors and the smallest number of hospital beds. the region (2 per 1,000 inhabitants compared to 7.7 in Paris, according to the National Institute for Demographic Research) has a particularly high mortality rate in this department during the first wave of Covid-19.

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