Racial/Ethnic Disparities in Post-acute Sequelae of SARS-CoV-2 Infection in New York: an EHR-Based Cohort Study from the RECOVER Program

Abstract

Background Compared to white individuals, Black and Hispanic individuals have higher rates of COVID-19 hospitalization and death. Less is known about racial/ethnic differences in post-acute sequelae of SARS-CoV-2 infection (PASC). Objective Examine racial/ethnic differences in potential PASC symptoms and conditions among hospitalized and non-hospitalized COVID-19 patients. Design Retrospective cohort study using data from electronic health records. Participants 62,339 patients with COVID-19 and 247,881 patients without COVID-19 in New York City between March 2020 and October 2021. Main Measures New symptoms and conditions 31–180 days after COVID-19 diagnosis. Key Results The final study population included 29,331 white patients (47.1%), 12,638 Black patients (20.3%), and 20,370 Hispanic patients (32.7%) diagnosed with COVID-19. After adjusting for confounders, significant racial/ethnic differences in incident symptoms and conditions existed among both hospitalized and non-hospitalized patients. For example, 31–180 days after a positive SARS-CoV-2 test, hospitalized Black patients had higher odds of being diagnosed with diabetes (adjusted odds ratio [OR]: 1.96, 95% confidence interval [CI]: 1.50—2.56, q<0.001) and headaches (OR: 1.52, 95% CI: 1.11—2.08, q=0.02), compared to hospitalized white patients. Hospitalized Hispanic patients had higher odds of headaches (OR: 1.62, 95% CI: 1.21—2.17, q=0.003) and dyspnea (OR: 1.22, 95% CI: 1.05—1.42, q=0.02), compared to hospitalized white patients. Among non-hospitalized patients, Black patients had higher odds of being diagnosed with pulmonary embolism (OR: 1.68, 95% CI: 1.20—2.36, q=0.009) and diabetes (OR: 2.13, 95% CI: 1.75—2.58, q<0.001), but lower odds of encephalopathy (OR: 0.58, 95% CI: 0.45—0.75, q<0.001), compared to white patients. Hispanic patients had higher odds of being diagnosed with headaches (OR: 1.41, 95% CI: 1.24—1.60, q<0.001) and chest pain (OR: 1.50, 95% CI: 1.35—1.67, q < 0.001), but lower odds of encephalopathy (OR: 0.64, 95% CI: 0.51—0.80, q<0.001). Conclusions Compared to white patients, patients from racial/ethnic minority groups had significantly different odds of developing potential PASC symptoms and conditions. Future research should examine the reasons for these differences.

Multidimensional Sleep Health Prior to SARS-CoV-2 Infection and Risk of Post–COVID-19 Condition

“…Date of birth, race and ethnicity (American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Pacific Islander, or White), and height were self-reported at cohort enrollment. We included race and ethnicity as a study variable because of the known racial and ethnic disparity in sleep health and PCC . Diet, including alcohol consumption, was measured in 2015 using a validated semiquantitative food frequency questionnaire .…”

“…We included race and ethnicity as a study variable because of the known racial and ethnic disparity in sleep health and PCC. 39,40 Diet, including alcohol consumption, was measured in 2015 using a validated semiquantitative food frequency questionnaire. 41,42 We adapted the Alternate Healthy Eating Index-2010 score to describe diet quality.…”

Post-COVID-19 condition in patients with autoimmune rheumatic diseases: the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study

“…The presence of comorbidities has been more consistently identified as a risk factor for the condition in published reports. 7 , 8 …”

Exploring risk factors for persistent neurocognitive sequelae after hospitalization for COVID‐19

“…We observed a longer length of hospitalization among those with [18 (7, 29.5) days] compared to those without [7 (5,19) days] persistent neurocognitive symptoms. Hospital stay length has been identified in other studies as a risk factor for PASC 7,24,25 .…”

“…We also evaluated risk factors for decreased patient‐reported cognitive function using the validated PROMIS measures. Ultimately, we identified several potential risk factors, most of which are sociodemographic factors 19,20 . Notably, we identified female sex, Hispanic ethnicity, and lower self‐reported socioeconomic status as factors associated with increased risk of developing neuro‐PASC in our cohort.…”