Cederström Agneta, Mkoma George Frederick, Benfield Thomas, Agyemang Charles, Nørredam Marie, Rostila Mikael
Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden.
BMC Med. 2025 Jan 29;23(1):53. doi: 10.1186/s12916-025-03900-x.
Many studies have found more severe COVID-19 outcomes in migrants and ethnic minorities throughout the COVID-19 pandemic, while recent evidence also suggests higher risk of longer-term consequences. We studied the risk of a long COVID diagnosis among adult residents in Sweden, dependent on country of birth and accounting for known risk factors for long COVID.
We used linked Swedish administrative registers between March 1, 2020 and April 1, 2023, to estimate the risk of a long COVID diagnosis in the adult population that had a confirmed COVID-19 infection. Poisson regressions were used to calculate incidence rate ratios (IRR) of long COVID by country/region of birth. The contribution of sex, preexisting health status, disease severity, vaccination status, and socioeconomic factors to differences in long COVID diagnosis by country/region of birth were further investigated.
Of the 1,869,188 persons diagnosed with COVID-19 that were included, 7539 had received a long COVID diagnosis. Compared with residents born in Sweden, we found higher risks of long COVID among migrants from East Europe (IRR: 1.44 CI: 1.29-1.60), Finland (IRR: 1.36 CI: 1.15-1.61), South Asia (IRR: 1.28 CI: 1.03-1.59), Other Asia (IRR: 1.35 CI: 1.13-1.62), Other Africa (IRR: 1.48 CI: 1.17-1.87), and the Middle East (IRR: 1.43 CI: 1.27-1.63) in models adjusted for age and sex. We discovered that disease severity, i.e., whether the person was hospitalized (IRR: 18.6 CI: 17.3-20.0) or treated in an intensive care unit (IRR: 120.5 CI: 111.7-129.8), primarily contributed to the higher risk of long COVID found in migrants while the contribution of vaccinations and social conditions were moderate. Preexisting health problems did not contribute to the increased risk of long COVID in migrants.
The greater exposure and impact of the COVID-19 virus among migrants also affected longer-term consequences. Disease severity was the most important risk factor for long COVID in migrants. The findings emphasize the need for targeted health interventions for migrant communities during an infectious disease pandemic, such as strategic vaccination campaigns and extending social insurance schemes, focusing on reducing disease severity to mitigate the longer-term health consequences of an infection.
许多研究发现，在整个新冠疫情期间，移民和少数族裔的新冠病毒疾病（COVID-19）结局更为严重，而最近的证据也表明其出现长期后果的风险更高。我们研究了瑞典成年居民中出现长期新冠诊断的风险，该风险取决于出生国家，并考虑了已知的长期新冠风险因素。
我们使用了瑞典2020年3月1日至2023年4月1日之间的关联行政登记数据，以估计确诊感染新冠病毒的成年人群中出现长期新冠诊断的风险。采用泊松回归分析按出生国家/地区计算长期新冠的发病率比（IRR）。进一步研究了性别、既往健康状况、疾病严重程度、疫苗接种状况和社会经济因素对不同出生国家/地区长期新冠诊断差异的影响。
在纳入研究的1,869,188例确诊感染新冠病毒的患者中，有7539例被诊断为长期新冠。与出生在瑞典的居民相比，我们发现来自东欧（IRR：1.44，CI：1.29 - 1.60）、芬兰（IRR：1.36，CI：1.15 - 1.61）、南亚（IRR：1.28，CI：1.03 - 1.59）、其他亚洲地区（IRR：1.35，CI：1.13 - 1.62）、其他非洲地区（IRR：1.48，CI：1.17 - 1.87）和中东地区（IRR：1.43，CI：1.27 - 1.63）的移民在调整年龄和性别后的长期新冠风险更高。我们发现，疾病严重程度，即患者是否住院（IRR：18.6，CI：17.3 - 20.0）或在重症监护病房接受治疗（IRR：120.5，CI：111.7 - 129.8），是导致移民长期新冠风险较高的主要因素，而疫苗接种和社会状况的影响适中。既往健康问题并未导致移民长期新冠风险增加。
新冠病毒在移民中的更大暴露和影响也会影响其长期后果。疾病严重程度是移民长期新冠最重要的风险因素。这些发现强调了在传染病大流行期间针对移民社区进行有针对性的健康干预的必要性，例如开展战略疫苗接种运动和扩大社会保险计划，重点是降低疾病严重程度，以减轻感染带来的长期健康后果。
