According to the Centers for Disease Control and Prevention (CDC), health disparities along racial lines are common in the U.S. Now, two studies suggest that Black and Hispanic Americans have higher rates of Long COVID symptoms and related health complications than their White counterparts, yet lower rates of Long COVID diagnoses.*

Racial health disparities in the U.S.

Growing research shows that people of color have been “profoundly and negatively impacted” by centuries of racism in the U.S., the CDC explains. Its widespread influence has created disparities in social determinants of health, which are fundamental drivers of health inequities in people of color. Data shows that, compared to Whites, racial and ethnic minorities in America have more sickness and death from obesity, diabetes, hypertension, heart disease, asthma, and many other conditions.

COVID-19 is now on that list, as well. Researchers at Weill Cornell write that Black and Hispanic Americans appear to have higher rates of hospitalization and mortality from COVID-19 than White people do. Whether or not this trend carries over to Long COVID has yet to be determined in robust studies, but higher rates of pre-existing conditions and lower socioeconomic status among these communities can increase their risk of Long COVID. 

What the researchers did

Two studies that are part of the National Institutes of Health’s RECOVER Initiative (Researching COVID to Enhance Recovery) investigated Long COVID racial disparities. One of the studies was led by the team at Weill Cornell. In the first study:

• Health records of more than 62,000 adults with a positive COVID-19 diagnosis were compared to the records of more than 247,000 adults with no history of COVID.

The second study was led by researchers at the University of North Carolina at Chapel Hill and the University of Tennessee. 

• Health records of nearly 34,000 adults and children diagnosed with Long COVID between October 2021 and May 2022 were examined. 

What they found

In the first study, Black and Hispanic adults made up half of the more than 13,000 people who had severe COVID-19 requiring hospitalization.

Over the months following infection:

• Severely ill Black adults were more likely than Whites to develop diabetes, headaches, and chest and joint pain, though less likely to have sleep issues, brain fog, or fatigue. Severely ill Hispanics showed a similar pattern, but experienced breathlessness rather than developing diabetes. 
• Mild-to-moderately ill Black adults were more likely than Whites to have lung clotting, chest and joint pain, anemia, or malnourishment, with Hispanic adults more likely to have dementia, headaches, chest pain, anemia, and diabetes. White adults were more likely to have brain fog and fatigue.

In the second study, researchers found that most patients who received a Long COVID diagnosis were White, non-Hispanic women living in areas with low poverty and better healthcare access, suggesting, the authors note, that not everyone with Long COVID is being diagnosed.

What it means

Columbia University professor and American Heart Association chief clinical science officer Mitchell S.V. Elkind, M.D. said the new findings suggest “there may be important differences in how long COVID manifests in different racial and ethnic groups.” Diagnostic codes, he said, may also be a factor.

“This research contributes to our understanding of symptom clusters in long COVID that may be differentiated by race, ethnicity, and influenced by social determinants of health,” said Gary H. Gibbons, M.D., director of the National Heart, Lung, and Blood Institute.

At this time, however, “It’s not clear what’s behind these symptom variations,” added study author Dhruv Khullar, who hopes the findings spark further research and discussion. 

*National Heart, Lung and Blood Institute. (2023, February 17). Research identifies potential long COVID racial disparities. MDLinx. https://www.mdlinx.com/news/research-identifies-potential-long-covid-racial-disparities/4wPrDJtGudLK1zKOgtmE8q