Associations between ethnicity and persistent physical and mental health symptoms experienced as part of ongoing symptomatic COVID-19.

Sindhu Bhaarrati Naidu, Anita Saigal, Amar Jitu Shah, Chibueze Ogbonnaya, Shiuli Bhattacharyya, Karthig Thillaivasan, Songyuan Xiao, Camila Nagoda Niklewicz, George Seligmann, Heba Majed Bintalib, John Robert Hurst, Marc Caeroos Isaac Lipman, Swapna Mandal
Author Information
  1. Sindhu Bhaarrati Naidu: Respiratory Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom. ORCID
  2. Anita Saigal: Respiratory Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom.
  3. Amar Jitu Shah: Respiratory Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom.
  4. Chibueze Ogbonnaya: Institute of Child Health, University College London, London, United Kingdom.
  5. Shiuli Bhattacharyya: Respiratory Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom.
  6. Karthig Thillaivasan: Respiratory Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom.
  7. Songyuan Xiao: Respiratory Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom. ORCID
  8. Camila Nagoda Niklewicz: Respiratory Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom.
  9. George Seligmann: Respiratory Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom.
  10. Heba Majed Bintalib: UCL Respiratory, University College London, London, United Kingdom.
  11. John Robert Hurst: Respiratory Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom.
  12. Marc Caeroos Isaac Lipman: Respiratory Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom.
  13. Swapna Mandal: Respiratory Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom.

Abstract

INTRODUCTION: Ethnicity can influence susceptibility to SARS-CoV-2 infection, hospitalisation and death. Its association with ongoing symptomatic COVID-19 is unclear. We assessed if, among a population followed up after discharge from hospital with COVID-19, adults from Asian, black, mixed and other backgrounds are at increased risk of physical and mental health symptoms.
METHODS: Adults discharged after hospitalisation with COVID-19 between 03/03/2020 and 27/11/2021 were routinely offered follow-up six to 12 weeks post-discharge and reviewed for ongoing symptomatic COVID-19, as defined by persisting physical symptoms (respiratory symptoms, fatigue, impaired sleep and number of other symptoms), mental health symptoms and inability to return to work if employed. Descriptive statistics and multiple regression analyses were used to compare differences in characteristics, follow-up outcomes and blood tests between ethnic groups. To account for possible selection bias, analyses were adjusted for propensity scores.
RESULTS: 986 adults completed follow-up: 202 (20.5%) Asian, 105 (10.6%) black, 18 (1.8%) mixed, 468 (47.5%) white and 111 (11.3%) from other backgrounds. Differences between groups included white adults being older than those from Asian/'other' backgrounds and black adults being more likely from deprived areas than those from Asian/white/'other' backgrounds. After adjusting for these differences, at follow-up, black adults had fewer respiratory (adjusted odds ratio 0.49 (0.25-0.96)) and other symptoms (adjusted count ratio 0.68 (0.34-0.99)) compared to white adults. There were otherwise no significant differences between ethnic groups in terms of physical health, mental health or ability to return to work if employed. These findings were not altered after adjustment for propensity scores.
CONCLUSIONS: In our population, despite having more co-morbidities associated with worse outcomes, adults from Asian, black, mixed and other ethnic backgrounds are not more likely to develop ongoing symptomatic COVID-19. However, it is important that healthcare services remain vigilant in ensuring the provision of timely patient-centred care.

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MeSH Term

Adult
Aged
Female
Humans
Male
Middle Aged
COVID-19
Ethnicity
Fatigue
Hospitalization
Mental Health

Word Cloud

Created with Highcharts 10.0.0adultssymptomsCOVID-19blackbackgroundshealthongoingsymptomaticphysicalmental0Asianmixedfollow-updifferencesethnicgroupsadjustedwhitehospitalisationpopulationrespiratoryreturnworkemployedanalysesoutcomespropensityscores5%likelyratioINTRODUCTION:EthnicitycaninfluencesusceptibilitySARS-CoV-2infectiondeathassociationunclearassessedamongfolloweddischargehospitalincreasedriskMETHODS:Adultsdischarged03/03/202027/11/2021routinelyofferedsix12weekspost-dischargerevieweddefinedpersistingfatigueimpairedsleepnumberinabilityDescriptivestatisticsmultipleregressionusedcomparecharacteristicsbloodtestsaccountpossibleselectionbiasRESULTS:986completedfollow-up:20220105106%1818%46847111113%DifferencesincludedolderAsian/'other'deprivedareasAsian/white/'other'adjustingfewerodds4925-096count6834-099comparedotherwisesignificanttermsabilityfindingsalteredadjustmentCONCLUSIONS:despiteco-morbiditiesassociatedworsedevelopHoweverimportanthealthcareservicesremainvigilantensuringprovisiontimelypatient-centredcareAssociationsethnicitypersistentexperiencedpart

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