Sally E Hayward1,2, Anna Deal1,2, Cherie Cheng1, Alison Crawshaw1, Miriam Orcutt3, Tushna F Vandrevala4, Marie Norredam5, Manuel Carballo6, Yusuf Ciftci7, Ana Requena-Méndez8, Christina Greenaway9, Jessica Carter1, Felicity Knights1, Anushka Mehrotra1, Farah Seedat10, Kayvan Bozorgmehr11, Apostolos Veizis12, Ines Campos-Matos13, Fatima Wurie14, Martin McKee2, Bernadette Kumar15, Sally Hargreaves1. 1. Institute for Infection and Immunity, St George's University of London, London, UK. 2. Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK. 3. Institute for Global Health, University College London, London, UK. 4. Faculty of Business and Social Sciences, Kingston University, London, UK. 5. Danish Research Centre for Migration, Ethnicity and Health, University of Copenhagen; Department of Infectious Diseases at Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark. 6. International Centre for Migration, Health, and Development, Geneva, Switzerland. 7. Doctors of the World UK, London, UK. 8. Department of Medicine, Karolinska Insitutet, Solna, Sweden; and Barcelona Insitute for Global Health (ISGlobal), University of Barcelona, Barcelona, Spain. 9. Department of Medicine, McGill University, Montreal, Canada. 10. Public Health England, London, UK. 11. Department of Population Medicine and Health and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany; Section for Health Equity Studies & Migration, Heidelberg University Hospital, Heidelberg, Germany. 12. Medecins Sans Frontieres Greece, Athens, Greece. 13. Public Health England; and UCL Collaborative Centre for Inclusion Health, London, UK. 14. Public Health England; and UCL Research Department of Epidemiology and Public Health, London, UK. 15. Norwegian Institute of Public Health, Oslo, Norway.
Abstract
BACKGROUND: Migrants in high-income countries may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations, indirect health and social impacts, and to determine key risk factors. METHODS: We did a systematic review following PRISMA guidelines (PROSPERO CRD42020222135). We searched multiple databases to 18/11/2020 for peer-reviewed and grey literature on migrants (foreign-born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts and risk factors using narrative synthesis. RESULTS: 3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected. Migrants experience risk factors including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement. CONCLUSIONS: Migrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health and policy responses to the pandemic. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups.
BACKGROUND: Migrants in high-income countries may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations, indirect health and social impacts, and to determine key risk factors. METHODS: We did a systematic review following PRISMA guidelines (PROSPERO CRD42020222135). We searched multiple databases to 18/11/2020 for peer-reviewed and grey literature on migrants (foreign-born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts and risk factors using narrative synthesis. RESULTS: 3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected. Migrants experience risk factors including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement. CONCLUSIONS: Migrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health and policy responses to the pandemic. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups.
Authors: Patrick Bodenmann; Brigitte Pahud-Vermeulen; Laurence Bouche; Javier Sanchis Zozaya; Murielle Bauermeister; Ahmed Berzig Journal: Rev Med Suisse Date: 2020-04-29
Authors: Shirley Sze; Daniel Pan; Clareece R Nevill; Laura J Gray; Christopher A Martin; Joshua Nazareth; Jatinder S Minhas; Pip Divall; Kamlesh Khunti; Keith R Abrams; Laura B Nellums; Manish Pareek Journal: EClinicalMedicine Date: 2020-11-12
Authors: Anna Deal; Sally E Hayward; Alison F Crawshaw; Lucy P Goldsmith; Charles Hui; Warren Dalal; Fatima Wurie; Mary-Ann Bautista; May Antonnette Lebanan; Sweetmavourneen Agan; Farah Amin Hassan; Kolitha Wickramage; Ines Campos-Matos; Sally Hargreaves Journal: Lancet Public Health Date: 2022-05-28
Authors: Alison F Crawshaw; Anna Deal; Kieran Rustage; Alice S Forster; Ines Campos-Matos; Tushna Vandrevala; Andrea Würz; Anastasia Pharris; Jonathan E Suk; John Kinsman; Charlotte Deogan; Anna Miller; Silvia Declich; Chris Greenaway; Teymur Noori; Sally Hargreaves Journal: J Travel Med Date: 2021-06-01 Impact factor: 8.490