Latin American Origin Is Not Associated with Worse Outcomes among Hospitalized Patients with COVID-19 in a Public Healthcare System

Abstract

Exploring differences in clinical outcomes based on race and origin among patients hospitalized for COVID-19 is a controversial issue. The ALC COVID-19 Registry includes all confirmed COVID-19 patients admitted to hospital from 3 March 2020 to 17 December 2020. The data were obtained from electronic health records in order to evaluate the differences in the clinical features and outcomes among European and Latin American patients. The follow-ups occurred after 156 days. A propensity score weighting (PSW) logistic regression model was used to estimate the odds ratio (OR, 95% CI) for Latin American origin and outcome associations. Of the 696 patients included, 46.7% were women, with a median age of 65 (IQR 53–67) years, 614 (88.2%) were European, and 82 (11.8%) were Latin American. Latin American patients were younger, with fewer comorbidities, and a higher incidence of extensive pneumonia. After adjusting for residual confounders, Latin American origin was not associated with an increased risk of death (PSW OR 0.85 (0.23–3.14)) or with the need for invasive mechanical ventilation (PSW OR 0.35 (0.12–1.03)). Latin American origin was associated with a shorter hospital stay, but without differences in how long the patient remained on mechanical ventilation. In a public healthcare system, the rates of death or mechanical ventilation in severe COVID-19 cases were found to be comparable between patients of European and Latin American origins.

Ethnicity and Clinical Outcomes in Patients Hospitalized for COVID-19 in Spain: Results from the Multicenter SEMI-COVID-19 Registry

“…In this large, nationwide, retrospective study of nearly 24,000 patients hospitalized in Spain with confirmed COVID-19, around 10% of the patients were ethnic minorities, with Latin Americans being the predominant group. These epidemiological data are similar to other Spanish series of patients with COVID-19 [ 10 , 11 , 12 , 13 , 14 , 15 , 17 ].…”

“…Regarding the clinical outcomes of COVID-19 in immigrant populations in Spain, the results are not consistent. Several small and/or single-center studies have shown an increased risk of ICU admission and IHM in individuals born in Latin American countries, but the model was not adjusted for comorbidities in these studies [ 10 , 12 , 13 ]. In another multicenter study from 18 Spanish hospitals that included 10,100 patients hospitalized for COVID-19 during the first wave of infections, 14.8% of whom were not born in Spain, Latin American patients also had higher rates of ICU admission and IHM, but, yet again, no adjustment for comorbidities or clinical and treatment variables was performed [ 15 ].…”

“…This influx of immigrants into Spain makes it necessary to study whether there are differences in the clinical progress of patients with COVID-19 according to their ethnicity. Few studies have analyzed the effect of ethnicity on patient progress in Spain [ 10 , 11 , 12 , 13 , 14 , 15 ] or other European Union countries [ 16 ]. Although the Spanish healthcare system is universal and accessibility is theoretically guaranteed to all [ 17 , 18 ], there is little information about ethnicity in health outcomes among patients in Spanish hospitals during the COVID-19 pandemic.…”