Racial/ethnic disparities in COVID-19 clinical outcomes: A comparison between Asian ethnic subgroups

Abstract Background Since the outbreak of COVID-19, general studies about relationship between COVID-19 clinical outcome and ethnicity have been performed on the overall ethnic groups, but studies on ethnic subgroups is limited. Methods We conducted a population-based retrospective cohort study on hospitalized patients with suspected/confirmed COVID-19 to evaluate whether ethnic background influences disease severity and clinical outcomes. Patients were categorized into three groups: mild, moderate, and severe to critical. Analyses were adjusted for socio-demographic and comorbidities. Results Among all hospitalized patients, in the unadjusted model, Afghans had a lower risk of severe to critical illness than Iranians (OR, 0.52; 95%CI, 0.41–0.64; P < 0.000). After adjusting for age, sex and comorbidities the risk remained lower in Afghans (OR, 0.69; 95%CI, 0.56–0.88; P < 0.003). But among positive cases was comparable even after full adjustment (OR, 0.86; 95%CI, 0.54–1.3; P < 0.547). Among all hospitalized patients, in the unadjusted model, the risk of death was comparable between Afghans and Iranians (OR, 1.037; 95%CI, 0.70–1.5; P < 0.003). After adjusting for age, sex and comorbidities, Afghans had a higher risk of death than Iranians (OR, 1.66; 95%CI, 1.08–2.55; P = 0.020). Similar results were observed in positive cases (OR, 2.34; 95%CI, 1.47–3.72; P = 0.000). Conclusions In this cohort study, Iranians represented more COVID-19-related symptoms and disease severity than Afghans; but mortality was higher in Afghans. The impact of COVID-19 may be different in various Asian ethnic groups