Black and Hispanic COVID-19 survivors are more likely to have persistent symptoms and health problems than their White peers but are less likely to receive a diagnosis, and the single available medical code for long COVID may not capture the wide variation in symptoms and severity, suggest two new studies from the National Health Institute's (NIH's) Researching COVID to Enhance Recovery (RECOVER) Initiative.
In one study, published in the Journal of General Internal Medicine, a team led by Weill Cornell Medicine researchers analyzed the health records of 62,339 adults who tested positive for COVID-19 in New York City from March 2020 to October 2021. The researchers monitored participants' health for 1 to 6 months and compared their outcomes to those of COVID-naïve adults.
One in four of the 13,106 hospitalized COVID-19 patients were Black or Hispanic, compared with 1 in 7 White patients. Non-White patients had very different long-COVID conditions and symptoms than their White counterparts.
Identifying potential racial and ethnic disparities in long COVID is an important step toward making sure we have an equitable response.
"Identifying potential racial and ethnic disparities in long COVID is an important step toward making sure we have an equitable response to the long-term consequences of coronavirus infection," lead author Dhruv Khullar, MD, MPP, said in a Cornell news release.
Long COVID may have many subtypes
The second study, led by University of North Carolina researchers, was published in BMC Medicine. The team analyzed the health records of 33,782 COVID patients of all ages at 34 US medical centers from October 2021 to May 2022.
The patients tended to be White, female, and non-Hispanic and lived in low-poverty communities and had greater healthcare access. The pattern suggests that not all long-COVID patients are being diagnosed, the authors said.
The symptoms could also be grouped into clusters of conditions and by age, suggesting that the only available medical code, "U09.9, post COVID-19 condition, unspecified," is insufficient. "It is likely that subtypes of long COVID exist, and such subtypes may correlate with specific underlying mechanisms that should be targeted by different interventions," they wrote.
It is likely that subtypes of long COVID exist.