Risk of long COVID and associated symptoms after acute SARS-COV-2 infection in ethnic minorities: a Danish nationwide cohort study

BackgroundEthnic minorities living in high-income countries have been disproportionately affected by COVID-19 in terms of infection rates and hospitalisations; however, less is known about long COVID in this population. Our aim was to examine the risk of long COVID and associated symptoms among ethnic minorities. Methods and FindingsA Danish nationwide register-based cohort study of individuals diagnosed with COVID-19 aged [≥]18 years (n=2 334 271) between January 2020 and August 2022. We calculated the risk of long COVID diagnosis and long COVID symptoms among ethnic minorities compared with native Danes using multivariable Cox proportional hazard regression and logistic regression, respectively. Ethnic minorities from North Africa (adjusted hazard ratio [aHR] 1.41; 95% CI 1.12-1.79), Middle East (aHR 1.38; 95% CI 1.24-1.55), Eastern Europe (aHR 1.35; 95% CI 1.22-1.49), and Asia (aHR 1.23; 95% CI 1.09-1.40) had significantly greater risk of long COVID diagnosis than native Danes in both unadjusted and adjusted models. In the analysis by largest countries of origin, the greater risks of long COVID diagnosis were found in Iraqis (aHR 1.56; 95% CI 1.30- 1.88), Turks (aHR 1.42; 95% CI 1.24-1.63), and Somalis (aHR 1.42; 95% CI 1.07-1.91) after adjustment for confounders. Significant factor associated with an increased risk of long COVID diagnosis was COVID-19 hospitalisation. Furthermore, the odds of reporting cardiopulmonary symptoms (including dyspnoea, cough, and chest pain) and any long COVID symptoms were higher among North African, Middle Eastern, Eastern European, and Asian than among native Danes in both unadjusted and adjusted models. ConclusionsBelonging to an ethnic minority group was significantly associated with an increased risk of long COVID indicating the need to better understand long COVID drivers and address care and treatment strategies in this population.