Increased risk for COVID-19 among Migrants from Latin-America, Caribbean, and Sub-Saharan Africa living in Spain

Guijarro, C.; Perez-Fernandez, E.; Gonzalez-Pineiro, B.; Melendez, V.; Goyanes, M. J.; Renilla, M. E.; Casas, M. L.; Sastre, I.; Velasco, M.; Investigators, Alcorcon COVID

Background: There is scant information regarding risk for COVID-19 among migrants or ethnic minorities in Europe. Methods. Population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 cases until April 25 (2020) among 152018 residents at the city of Alcorcon (Spain) attended at the only public hospital serving this city. Crude incident rates for Spaniards and migrants from different areas of the world were estimated. Age and sex-adjusted relative risks for COVID19 were estimated by negative polynomial regression. Findings. PCR confirmed COVID-19 cumulative incidence was 6.81 cases per 1000 inhabitants among residents of Alcorcon. The crude incidence among migrants (n=20419) was higher than among Spaniards (n=131599): 8.81 and 6.51 and per 1000 inhabitants respectively (p<0.001). By regions of the world, crude cumulative COVID-19 incidences were Asia 2.1, European Union 2.4, Northern Africa 3.6, Russia & East Europe 4.4, Sub-Saharan Africa 11.2, Caribbean 18.3 and Latin-America 20.8 per 1000 inhabitants. By negative polynomial logistic regression, adjusted for age and sex, relative risks (RR) for COVID-19 were not significantly different from Spaniards for individuals from Europe, Asia or Northern Africa. In contrast, there was an increased risk for Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p=0.007), Caribbean (RR 6.35, 95% CI 3.83-10.55, p<0.001) and Latin-America (RR 6.92, 95% CI 4.49-10.67, p <0.001). Interpretation. There was a marked increased risk for COVID-19 among migrants from Sub-Saharan Africa, Caribbean and Latin-America residing in Spain. Our data suggest a heretofore unreported increased risk in these populations that may deserve special attention.