COVID-19 clinical outcomes and nationality: results from a Nationwide registry in Kuwait
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RESEARCH ARTICLE
Open Access
COVID-19 clinical outcomes and nationality: results from a Nationwide registry in Kuwait Hala Hamadah1,2, Barrak Alahmad3, Mohammad Behbehani1, Sarah Al-Youha2, Sulaiman Almazeedi2, Mohannad Al-Haddad2, Mohammad H. Jamal2 and Salman Al-Sabah2,4*
Abstract Background: In light of the COVID-19 pandemic, many have flagged racial and ethnic differences in health outcomes in western countries as an urgent global public health priority. Kuwait has a unique demographic profile with two-thirds of the population consisting of non-nationals, most of which are migrant workers. We aimed to explore whether there is a significant difference in health outcomes between non-Kuwaiti and Kuwaiti patients diagnosed with COVID-19. Methods: We used a prospective COVID-19 registry of all patients (symptomatic and asymptomatic) in Kuwait who tested positive from February 24th to April 20th, 2020, collected from Jaber Al-Ahmad Al-Sabah Hospital, the officially-designated COVID-19 healthcare facility in the country. We ran separate logistic regression models comparing non-Kuwaitis to Kuwaitis for death, intensive care unit (ICU) admission, acute respiratory distress syndrome (ARDS) and pneumonia. Results: The first 1123 COVID-19 positive patients in Kuwait were all recruited in the study. About 26% were Kuwaitis and 73% were non-Kuwaiti. With adjustments made to age, gender, smoking and selected co-morbidities, non-Kuwaitis had two-fold increase in the odds of death or being admitted to the intensive care unit compared to Kuwaitis (OR: 2.14, 95% CI 1.12–4.32). Non-Kuwaitis had also higher odds of ARDS (OR:2.44, 95% CI 1.23–5.09) and pneumonia (OR: 2.24, 95% CI 1.27–4.12). Conclusion: This is the first study to report on COVID-19 outcomes between Kuwaiti and non-Kuwaiti patients. The current pandemic may have amplified the differences of health outcomes among marginalized subpopulations. A number of socioeconomic and environmental factors could explain this health disparity. More research is needed to advance the understanding of policymakers in Kuwait in order to make urgent public health interventions. Keywords: Migrant workers, Kuwait, COVID-19, Nationality, Health disparity
* Correspondence: [email protected] 2 Jaber Al-Ahmad Al-Sabah Hospital, Ministry of Health, Kuwait City, Kuwait 4 Faculty of Medicine, Kuwait University, Kuwait City, Kuwait Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the art
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