key: cord-0691358-6jzge81x authors: Díaz-Menéndez, Marta; Trigo, Elena; Borobia, Alberto M.; Arsuaga, Marta; de la Calle-Prieto, Fernando; de Miguel Buckley, Rosa; Lago, Mar; Arribas, José R. title: Presenting characteristics and outcomes of migrants in a cohort of hospitalized patients with COVID-19: Does the origin matter? date: 2021-03-20 journal: Travel Med Infect Dis DOI: 10.1016/j.tmaid.2021.102027 sha: 1a7af4af8b191c739cf224f0693979163995afe2 doc_id: 691358 cord_uid: 6jzge81x nan Since the first COVID-19 infected patient was identified in Spain in January 2020, the number of cases have rapidly increased with over 1,850,000 infected people as of December 20 th [1] . Spain is a country with a high rate of migrants and consequently a significant number of non-natives have been affected by this disease [2] . Lower access to the health system and greater social vulnerability among other barriers have been linked with the differences in infection rates, need for hospitalization, and COVID-19related death among migrants [3] . We aimed to evaluate if COVID-19 presentation and outcomes differed in migrants from those of Spanish natives. We characterize the first consecutive 486 migrant adult patients (defined as those citizens living in Spain but born in any other country) with confirmed SARS-CoV-2 infection hospitalized from February 25 th (first cases admitted in our center) to April 19 th , 2020 to La Paz University Hospital (Madrid), included in our previously described COVID19@HULP cohort [4] . The data were compared with those of 1740 Spanish natives admitted in the same time-period. Among the 486 migrants, most were from South America (73.5%), mainly from Ecuador (27.7%), Peru (18.5%) and Colombia (14%). Median age was 47 years, 56.6% were female, and up to 65.4% had at least one comorbidity, mainly arterial hypertension (23.3%). Nearly 5% were admitted to ICU and 7% died during hospitalization (Table 1) . Compared to Spanish, infected migrants were younger and less likely to have comorbidities at presentation, were more likely to have dry cough, dyspnea, headache, ageusia and anosmia but less likely to have O2 saturation below 90% at admission. ICU admissions, although higher, didn´t show statistical differences in both groups, whereas mortality was significantly lower in migrants. The multivariate analysis showed that being a migrant decreased the probability of dying (OR: 0.22; 95% CI 0.15-0.33; P<0.001) after adjusting for sex, age and comorbidities. Of note, migrants represent 21.8% of all hospitalized patients in our cohort. This percentage far exceeds the proportion of non-native people living in the catchment area for our center, estimated in 15.1% [5]; those migrants frequently live in overcrowded households which facilitates transmission of SARS-CoV-2. It is necessary to study whether there are other specific factors predisposing migrants to be more vulnerable to this infection and its complications, as has been shown in other respiratory diseases [6]. We believe that, although the high rates of infection and consulting later than Spanish natives, being a younger and healthier population may have conditioned a more favorable outcome of the disease in this group. Despite these findings, the relatively small number of patients may lack sufficient statistical power to show differences between natives and non-natives. More diversity in the geographic origin of the migrants would contribute to the better characterization of the differences between the two groups. Our study highlights the importance of studying the behavior of this disease in different populations to try to identify predictive factors that may impact on the clinical manifestations and evolution of the disease. [ 460 (20.7) 426 (24.5) 34 (7.0) < 0.001 Abbreviations: ICU: Intensive care Unit; IQR: interquartile range; n-s: non-significant; SatO2, oxygen saturation * areas according to WHO Regions; ** 31 patients were classified as non-native, but no country of origin was documented; † Calculate on the basis of the total cohort of 2226; ‡ excluding people Spanish natives; § Obesity was defined as a body-mass index (the weight in kilograms divided by the square of the height in meters) of 30 or higher. Article Title: Characteristics of migrants in a cohort of patients with COVID-19: Does the origin matter? Author name : Femando de la Calle Prieto Travel Medici11e a,rd hifectious Disease requires that ali authors sign a declaration of conflicting interests. lfyou have nothing to declare in any ofthese categories then this should be stated. A conflicting interest exists when professional judgement conceming a primary interest (such as patient's welfare or the validity of research) may be influenced by a secondary interest (such as financia! gain or personal rivalry). It may arise for the authors when they have financia! interest that may influence their interpretation of their results or those of others. Examples of potential conflicts of interest include employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, and grants or other funding. Ali sources offunding should also be acknowledged and you should declare any involvement of study sponsors in the study design; collection, analysis and interpretation of data; the writing of the manuscript; the decision to submit the manuscript for publication. Ifthe study sponsors had no such involvement, this should be stated. Signature (a scanned signature is acceptable, but each author must sign) Enfermedad por el nuevo coronavirus, COVID-19. Información actualizada sobre el brote How Do Presenting Symptoms and Outcomes Differ by Race/Ethnicity Among Hospitalized Patients with COVID-19 Infection? Experience in Massachusetts A cohort of patients with COVID-19 in a major teaching hospital in Europe A conflicting interest exists when professional judgement conceming a primary interest (such as patient's welfare or the validity of research) may be influenced by a secondary ínterest (such as financia! gain or personal rivalry). lt may aríse for the authors when they have financia! interest that may influence their interpretation of their results or those of others. Examples of potential conflicts of interest include employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, and grants or other funding. Funding Source All sources offunding should also be acknowledged and you should declare any involvement ofstudy sponsors in the study design; collection, analysis and interpretation of data; the writing of the manuscript; the decision to submit the manuscript for publication. Ifthe study sponsors had no such involvement, this should be stated. Signature (a scanned signature is acceptable, but each author must sign) Article Title: Chnractcristics of migrnnts in n cohort of patients with COVlD-19: Docs the origin mntter? Author name : Elena Trigo 1'ravel Medicine attd hrfectlm,s Dl~·ease requires that ali authors sign a declaration of conflicting interests. lf you have nothing to declare in any ofthese categories then this should be stated. A conflicting interest exists when professional judgement conceming a primary interest (such as patient's welfare or the validity of research) may be influenced by a secondary interest (such as financia! gain or personal rivalry). It may arise for the authors when they have financia! interest that may influence their interpretation of their results or those of others. Examples of potential conflicts of interest include employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, and grants or other funding. Ali sources offunding should also be acknowledged and you should declare any involvement ofstudy sponsors in the study design; collection, analysis and interpretation of data; the writing of the manuscript; the decision to submit the manuscript for publication. lfthe study sponsors had no such involvement, this should be stated. Signature (a scanned signature is acceptable, but each author must sign) A contlicting interest exists when professional judgement conceming a primary interest (such as patient's welfare or the validity of research) may be influenced by a secondary interest (such as financia! gain or personal rivalry). lt may arise for the authors when they have financia! interest that may influence their interpretation of their results or those of others. Examples of potential conflicts of interest include employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, and grants or other funding. Funding Source AII sources of funding should also be acknowledged and you should declare any involvement of study sponsors in the study design; collection, analysis and interpretation of data; the writing ofthe manuscript; the decision to submit the manuscript for publication. Ifthe study sponsors had no such involvement, this should be stated. Signa tu re but each a a scanned signature is acceptable, ormustL---