Racial/Ethnic Disparities in Exposure, Disease Susceptibility, and Clinical Outcomes during COVID-19 Pandemic in National Cohort of Adults, United States

We examined racial/ethnic disparities for COVID-19 se-roconversion and hospitalization within a prospective co-hort (n = 6,740) in the United States enrolled in March 2020 and followed-up through October 2021. Potential SARS-CoV-2 exposure, susceptibility to COVID-19 complications, and access to healthcare varied by race/ethnicity. Hispanic and Black non-Hispanic participants had more exposure risk and difficulty with healthcare ac-cess than white participants. Participants with more ex-posure had greater odds of seroconversion. Participants with more susceptibility and more barriers to healthcare had greater odds of hospitalization. Race/ethnicity posi-tively modified the association between susceptibility and hospitalization. Findings might help to explain the disproportionate burden of SARS-CoV-2 infections and complications among Hispanic/Latino/a and Black non-Hispanic persons. Primary and secondary prevention ef-forts should address disparities in exposure, vaccination, and treatment for COVID-19.

Automated summary

This study examined racial/ethnic disparities in COVID-19 seroconversion and hospitalization. The findings showed that Hispanic and Black non-Hispanic participants had higher exposure risk and difficulty in accessing healthcare, and participants with more exposure and susceptibility had higher odds of seroconversion and hospitalization. The study highlighted the importance of addressing disparities in exposure, vaccination, and treatment for COVID-19 among different racial/ethnic groups.