Black Patients Underdiagnosed With Long COVID In The US Compared With White Patients

Area of Science:

• Public Health
• Epidemiology
• Health Disparities

Background:

• Long COVID presents significant health challenges with diagnosis hindered by subjective criteria and unequal healthcare access.
• Variations in diagnosis and treatment underscore the need to investigate potential disparities in care.

Purpose of the Study:

• To examine the association between race and ethnicity and the likelihood of receiving a long COVID diagnosis.
• To identify potential diagnostic biases in long COVID assessment across different racial and ethnic groups.

Main Methods:

• Analysis of electronic health records from 2.4 million patients diagnosed with acute COVID-19 in the US (January 2022 - March 2023).
• Evaluation of 222 symptoms and long COVID diagnoses (ICD-10 code U09.9) within 12 months post-infection.
• Statistical assessment of long COVID diagnosis rates across six race and ethnicity categories, adjusting for covariates and symptom presence.

Main Results:

• Black patients were less likely to be diagnosed with long COVID compared to White patients when symptoms were present and healthcare monitoring was frequent.
• No statistically significant differences in long COVID diagnosis rates were observed for other racial and ethnic groups compared to White patients.
• A small but significant difference in diagnosis likelihood suggests potential diagnostic bias.

Conclusions:

• Findings indicate a potential diagnostic bias against Black patients in the identification of long COVID.
• Addressing diagnostic disparities is crucial for ensuring equitable care and management of long COVID.
• Further research is needed to understand and mitigate biases in long COVID diagnosis.