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Clinical outcomes and risk factors for COVID-19 among migrant populations in high-income countries: a systematic review.

Hayward, SE; Deal, A; Cheng, C; Crawshaw, A; Orcutt, M; Vandrevala, TF; Norredam, PM; Carballo, M; Ciftci, Y; Requena-Méndez, A; et al. Hayward, SE; Deal, A; Cheng, C; Crawshaw, A; Orcutt, M; Vandrevala, TF; Norredam, PM; Carballo, M; Ciftci, Y; Requena-Méndez, A; Greenaway, C; Carter, J; Knights, F; Mehrotra, A; Seedat, F; Bozorgmehr, PK; Veizis, A; Campos-Matos, I; Wurie, F; McKee, PM; Kumar, PB; Hargreaves, S; ESCMID Study Group for Infections in Travellers and Migrants (ES (2021) Clinical outcomes and risk factors for COVID-19 among migrant populations in high-income countries: a systematic review. J Migr Health, 3. p. 100041. ISSN 2666-6235 https://doi.org/10.1016/j.jmh.2021.100041
SGUL Authors: Hargreaves, Sally

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Abstract

Background: Migrants in high-income countries may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations, indirect health and social impacts, and to determine key risk factors. Methods: We did a systematic review following PRISMA guidelines (PROSPERO CRD42020222135). We searched multiple databases to 18/11/2020 for peer-reviewed and grey literature on migrants (foreign-born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts and risk factors using narrative synthesis. Results: 3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected. Migrants experience risk factors including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement. Conclusions: Migrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health and policy responses to the pandemic. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups.

Item Type: Article
Additional Information: © 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Keywords: ESCMID Study Group for Infections in Travellers and Migrants (ESGITM)
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: J Migr Health
ISSN: 2666-6235
Language: eng
Dates:
DateEvent
22 April 2021Published
7 April 2021Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
MR/N013638/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
NIHR300072National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
SBF005\1111Academy of Medical Scienceshttp://dx.doi.org/10.13039/501100000691
NIHR300290National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
PubMed ID: 33903857
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/113203
Publisher's version: https://doi.org/10.1016/j.jmh.2021.100041

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