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Epidemiology of COVID-19 and its cardiac and neurological complications among Chinese and South Asians in Ontario: wave 1, 2 and 3


Background — Although we had previously reported the cardiac and neurological outcomes of Chinese and South Asian Ontarians in wave 1 of COVID-19, data on subsequent waves of COVID-19 remain unclear. This is an extension study of this cohort in waves 2 and 3.

Methods — We identified adult Ontarians with a positive COVID-19 PCR test between January 1, 2020 to June 30, 2021 and they were classified as Chinese or South Asians using a validated surname algorithm and compared their outcomes of mortality, cardiac and neurological complications with the general population using multivariable logistic regression models.

Results — Compared to the general population (N = 439,977), Chinese (N = 15,208) were older (mean age 44.2 vs 40.6 years, p < 0.001) while South Asians (N = 46,333) were younger (39.2 years p < 0.001). Chinese had a higher 30-day mortality (Odds ratio [OR] 1.44; 95% CI 1.28-1.61) and hospitalization or emergency department (ED) visits (1.14; 1.09-1.28) and with a trend towards higher cardiac complications (1.03; 0.87-1.12) and neurological complications (1.23; 0.96-1.58). South Asians had a lower 30-day mortality (0.88; 0.78-0.98) but a higher hospitalization or ED visits (1.17; 1.14-1.20) with a trend towards lower cardiac complications (0.76; 0.67-0.87) and neurological complications (0.89; 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 neurological outcomes, and healthcare use among patients with COVID-19, requiring further studies to understand factors driving these differences.



Chu JY, Moe GW, Vyas MV, Chen R, Chow CM, Gupta M, Kaliwal Y, Koh M, Ko DT, Liu PP. CJC Open. 2022; Jun 27 [Epub ahead of print].

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