Ethnic Differences in Symptom Burden, Work and Daily Life: A Study of Long COVID Patients in Denmark

BACKGROUND: Ethnic minorities appear to be at higher risk of long COVID. Our objective was to estimate ethnic differences in the burden of long COVID symptoms and their impact on daily life and occupational status.

METHODS: Retrospective cohort study of adults (≥ 18 years) admitted to a Long COVID Clinic, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark, from February 2021 through November 2022. Data from symptom questionnaires were linked to clinical data from patient records and national register data. Using regression models, we calculated the burden and number of long COVID symptoms as well as the risk of certain symptom categories, of being on sick leave, of loss of independence, and of having returned to usual leisure activities.

RESULTS: A total of 864 patients from the long COVID clinic were included; hereof 31.2% were ethnic minorities. Compared to patients of Danish origin, ethnic minorities had an 18.32% higher mean burden of long COVID symptoms (adjusted mean difference (MD adj) 3.23, 95% confidence interval (CI): 1.67;4.78) and experienced 18.56% more long COVID symptoms on average (MD adj 1.56, 95% CI: 0.86;2.26). Ethnic minorities were more likely to experience cardio-pulmonary, psychological, and gastrointestinal symptoms. However, compared to patients of Danish origin, ethnic minorities had lower odds of being on sick leave (adjusted odds ratio (OR adj) 0.61, 95% CI: 0.40;0.94) and of having returned to usual leisure activities (OR adj 0.68, 95% CI: 0.48;0.94).

CONCLUSIONS: Ethnic minorities experienced a higher number and symptom burden of long COVID symptoms along with a higher risk of certain symptom categories, notably psychological symptoms. However, ethnic minorities had lower odds of being on sick leave. Additional research is needed into the explanations of the disparities identified in this study.