Joseph Y Chu1,2, Gordon W Moe3,4, Manav V Vyas5, Robert Chen2, Chi-Ming Chow3,4, Milan Gupta4, Yosuf Kaliwal6, Maria Koh6, Dennis T Ko6,7, Peter P Liu4,8,9. 1. Division of Neurology, Department of Medicine, William Osler Health System, Toronto, Ontario, Canada. 2. Division of Neurology, Department of Medicine, Toronto Western Hospital-University Health Network, Toronto, Ontario, Canada. 3. Division of Cardiology, Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada. 4. Division of Cardiology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. 5. Division of Neurology, Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada. 6. ICES, Toronto, Ontario, Canada. 7. Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. 8. University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada. 9. Department of Medicine and Cellular & Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Abstract
Background: Although we had previously reported the cardiac and neurologic outcomes of Chinese and South Asian Ontarians in wave 1 of COVID-19, data on subsequent waves of COVID-19 remain unexamined. This is an extension study of this cohort in waves 2 and 3. Methods: We identified adult Ontarians with a positive COVID-19 polymerase chain reaction test from January 1, 2020 to June 30, 2021, and they were classified as being Chinese or South Asian using a validated surname algorithm; we compared their outcomes of mortality, and cardiac and neurologic complications with those of the general population using multivariable logistic regression models. Results: Compared to the general population (n = 439,977), the Chinese population (n = 15,208) was older (mean age 44.2 vs 40.6 years, P < 0.001) and the South Asian population (n = 46,333) was younger (39.2 years, P < 0.001). The Chinese population had a higher 30-day mortality (odds ratio [OR] 1.44; 95% confidence interval [CI] 1.28-1.61) and more hospitalization or emergency department visits (OR, 1.14; 95% CI, 1.09-1.28), with a trend toward a higher incidence of cardiac complications (OR, 1.03; 95% CI, 0.87-1.12) and neurologic complications (OR, 1.23; 95% CI, 0.96-1.58). South Asians had a lower 30-day mortality (OR, 0.88; 95% CI, 0.78-0.98) but a higher incidence of hospitalization or emergency department visits (OR, 1.17; 95% CI, 1.14-1.20) with a trend toward a lower incidence of cardiac complications (OR, 0.76; 95% CI, 0.67-0.87) and neurologic complications (OR, 0.89; 95% CI, 0.73-1.09). There was also a significant difference in these outcomes between wave 1, 2 and 3, with a greater mortality in all groups in waves 2 and 3. Conclusions: Ethnicity continues to be an important determinant of mortality, cardiac and neurologic outcomes, and healthcare use among patients with COVID-19, requiring further studies to understand factors driving these differences.
Background: Although we had previously reported the cardiac and neurologic outcomes of Chinese and South Asian Ontarians in wave 1 of COVID-19, data on subsequent waves of COVID-19 remain unexamined. This is an extension study of this cohort in waves 2 and 3. Methods: We identified adult Ontarians with a positive COVID-19 polymerase chain reaction test from January 1, 2020 to June 30, 2021, and they were classified as being Chinese or South Asian using a validated surname algorithm; we compared their outcomes of mortality, and cardiac and neurologic complications with those of the general population using multivariable logistic regression models. Results: Compared to the general population (n = 439,977), the Chinese population (n = 15,208) was older (mean age 44.2 vs 40.6 years, P < 0.001) and the South Asian population (n = 46,333) was younger (39.2 years, P < 0.001). The Chinese population had a higher 30-day mortality (odds ratio [OR] 1.44; 95% confidence interval [CI] 1.28-1.61) and more hospitalization or emergency department visits (OR, 1.14; 95% CI, 1.09-1.28), with a trend toward a higher incidence of cardiac complications (OR, 1.03; 95% CI, 0.87-1.12) and neurologic complications (OR, 1.23; 95% CI, 0.96-1.58). South Asians had a lower 30-day mortality (OR, 0.88; 95% CI, 0.78-0.98) but a higher incidence of hospitalization or emergency department visits (OR, 1.17; 95% CI, 1.14-1.20) with a trend toward a lower incidence of cardiac complications (OR, 0.76; 95% CI, 0.67-0.87) and neurologic complications (OR, 0.89; 95% CI, 0.73-1.09). There was also a significant difference in these outcomes between wave 1, 2 and 3, with a greater mortality in all groups in waves 2 and 3. Conclusions: Ethnicity continues to be an important determinant of mortality, cardiac and neurologic outcomes, and healthcare use among patients with COVID-19, requiring further studies to understand factors driving these differences.
Authors: Idan Roifman; Rakesh C Arora; David Bewick; Chi-Ming Chow; Brian Clarke; Simone Cowan; Anique Ducharme; Kenneth Gin; Michelle Graham; Anil Gupta; Sean Hardiman; Michael Hartleib; Simon Jackson; Davinder Jassal; Mustapha Kazmi; Yoan Lamarche; Jean-François Légaré; Howard Leong-Poi; Samer Mansour; Ariane Marelli; Marc Ruel; Gary Small; Larry Sterns; Ricky Turgeon; Sean Virani; Harindra C Wijeysundera; Kenny Wong; David A Wood; Shelley Zieroth; Gurmeet Singh; Andrew D Krahn Journal: Can J Cardiol Date: 2020-12-09 Impact factor: 5.223
Authors: Mina K Chung; David A Zidar; Michael R Bristow; Scott J Cameron; Timothy Chan; Clifford V Harding; Deborah H Kwon; Tamanna Singh; John C Tilton; Emily J Tsai; Nathan R Tucker; John Barnard; Joseph Loscalzo Journal: Circ Res Date: 2021-04-15 Impact factor: 17.367
Authors: Geehan Suleyman; Raef A Fadel; Kelly M Malette; Charles Hammond; Hafsa Abdulla; Abigail Entz; Zachary Demertzis; Zachary Hanna; Andrew Failla; Carina Dagher; Zohra Chaudhry; Amit Vahia; Odaliz Abreu Lanfranco; Mayur Ramesh; Marcus J Zervos; George Alangaden; Joseph Miller; Indira Brar Journal: JAMA Netw Open Date: 2020-06-01
Authors: Joseph Y Chu; Yosuf Kaliwal; Maria Koh; Robert Chen; Chi-Ming Chow; Dennis T Ko; Peter P Liu; Gordon W Moe Journal: Can J Neurol Sci Date: 2021-06-24 Impact factor: 2.915