AbstractObjectiveTo evaluate the COVID-19 incidence among migrants from different areas of the world as compared to Spaniards living in AlcorcónDesignPopulation-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 cases until April 25 (2020) among adult residents at Alcorcón (Spain) attended at the only public hospital serving this city. Crude incident rates for Spaniards and migrants from different areas of the world were estimated. Age and sex-adjusted relative risks for COVID19 were estimated by negative bomial regression.SettingUniversity public Hospital at Alcorcón, Madrid, SpainParticipantsAll adult residents living in Alcorcon classified by their country and region of the world of origin.Main outcomePCR confirmed COVID-19.ResultsPCR confirmed COVID-19 cumulative incidence was 6.81 cases per 1000 inhabitants among residents of Alcorcón. The crude incidence among migrants (n=20419) was higher than among Spaniards (n=131599): 8.81 and 6.51 and per 1000 inhabitants respectively (p<0.001).By regions of the world, crude cumulative COVID-19 incidence rates were: European Union 2.38, Asia 2.01,, Northern Africa 3.59, East ern Europe 4.37, Sub-Saharan Africa 11.24, Caribbean 18.26 and Latin-America 20.77 8 per 1000 inhabitants. Migrant residents were markedly younger than Spaniards (median age 52 vs 73 years, p<0.001). By negative binomial regression, adjusted for age and sex, relative risks (RR) for COVID-19 were not significantly different from Spaniards for individuals from Europe, Asia or Northern Africa. In contrast, there was an increased risk for Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p=0.007), Caribbean (RR 6.35, 95% CI 3.83-10.55, p<0.001) and Latin-America (RR 6.92, 95% CI 4.49-10.67, p <0.001).ConclusionsThere was a marked increased risk for COVID-19 among migrants from Sub-Saharan Africa, Caribbean and Latin-America residing in Spain. The reasons underlying this increased risk and health and social implications deserve further attention.What is known about the topicRecent reports suggest an increased burden of COVID-19 among migrants or ethnic minorities in the United Kingdom and the USA, particularly regarding mortality. Reports have failed to dissociate clinical outcomes from differences in access to medical care or pre-existing medical conditions. There is no information regarding COVID risk for latinos in countries with universal health coverageWhat this study addMigrants from subsaharian Africa resident in Spain exhibit an increased risk for COVID-19. This risk is further increased for migrants from the Caribbean and Latin-America and cannot be attributed to unequal access to medical care. Studies in countries with universal health coverage may help to dissociate COVID burden in migrants and ethnic populations from access to health care.
Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health