Open Forum Infect Dis . Ethnic Differences in Coronavirus Disease 2019 Hospitalization and Hospital Outcomes in a Multiethnic Population in the Netherlands

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Open Forum Infect Dis


. 2022 May 17;9(6):ofac257.
doi: 10.1093/ofid/ofac257. eCollection 2022 Jun.
Ethnic Differences in Coronavirus Disease 2019 Hospitalization and Hospital Outcomes in a Multiethnic Population in the Netherlands


Didier Collard ¹ , Karien Stronks ² , Vanessa Harris ³ , Liza Coyer ³ , Kees Brinkman ⁴ , Martijn Beudel ⁵ , Nejma Bokhizzou ⁶ , Renee A Douma ⁷ , Paul Elbers ⁸ , Henrike Galenkamp ² , Marije Ten Wolde ⁷ , Maria Prins ³ , Bert Jan H van den Born ¹ , Charles Agyemang ²



Affiliations

• PMID: 35783684
• PMCID: PMC9129177
• DOI: 10.1093/ofid/ofac257

Abstract

Background: Evidence from the United States and United Kingdom suggests that ethnic minority populations are at an increased risk for developing severe coronavirus disease 2019 (COVID-19); however, data from other West-European countries are scarce.
Methods: We analyzed data from 1439 patients admitted between February 2020 and January 2021 to 4 main hospitals in Amsterdam and Almere, the Netherlands. Differences in the risk for hospitalization were assessed by comparing demographics to the general population. Using a population-based cohort as reference, we determined differences in the association between comorbidities and COVID-19 hospitalization. Outcomes after hospitalization were analyzed using Cox regression.
Results: The hospitalization risk was higher in all ethnic minority groups than in those of Dutch origin, with age-adjusted odds ratios ranging from 2.2 (95% confidence interval [CI], 1.7-2.6) in Moroccans to 4.5 (95% CI, 3.2-6.0) in Ghanaians. Hypertension and diabetes were similarly associated with COVID-19 hospitalization. For all other comorbidities, we found differential associations. Intensive care unit admission and mortality during 21-day follow-up after hospitalization was comparable between ethnicities.
Conclusions: The risk of COVID-19 hospitalization was higher in all ethnic minority groups compared to the Dutch, but the risk of adverse outcomes after hospitalization was similar. Our results suggest that these inequalities may in part be attributable to comorbidities that can be prevented by targeted public health prevention measures. More work is needed to gain insight into the role of other potential factors such as social determinants of health, which might have contributed to the ethnic inequalities in COVID-19 hospitalization.

Keywords: COVID-19; The Netherlands; ethnic inequalities; hospitalization; migrants health; outcomes.