Variation in clinical presentation, complications and outcomes for Māori and Pacific peoples among hospitalised adults with COVID-19 in 2022, Aotearoa New Zealand.

Abstract

Background: Pacific region-specific data on the clinical course of COVID-19 are limited. We aimed to describe clinical features and outcomes from Aotearoa New Zealand patients, focusing on Māori and Pacific peoples.

Methods: We conducted a retrospective cohort study among adults (≥16 years) hospitalised due to COVID-19 at 11 hospitals from January to May 2022. We included all Māori and Pacific patients and every second non-Māori, non-Pacific (NMNP) patient using data from chart review and national datasets.

Results: Of 2319 patients, 582 (25%) were Māori, 914 (39%) Pacific peoples and 862 NMNP (median age 52, 57 and 63 years respectively). Vaccination coverage (≥2 doses) was 73.4% (n = 437) for Māori, 76.7% (n = 701) for Pacific peoples (n = 701) and 84.8% (n = 731) for NMNP. Among 832 (35.9%) with complications, Māori had a greater risk than NMNP of acute kidney injury (risk ratio (RR) 1.87, P < 0.001), cardiac arrhythmia (RR = 1.60, P = 0.023), shock (RR = 2.64, P = 0.005), myocardial infarction (RR 2.21, P = 0.042), cardiac arrest (RR 2.68, P = 0.046) and acute respiratory distress syndrome (RR = 2.81, P = 0.008). Pacific patients experienced a greater risk than NMNP of acute kidney injury (RR = 2.18, P < 0.001) and pneumonia (RR = 1.32, P = 0.047) and a lower risk of thromboembolism (RR = 0.35, P = 0.004) and myocarditis/pericarditis (RR = 0.23, P = 0.003). During admission, 23 (3.3%) Māori, 36 (3.9%) Pacific and 28 (3.2%) NMNP patients died, with no difference in age-standardised mortality.

Conclusions: The clinical course of patients hospitalised by COVID-19 varied between ethnic groups, likely reflecting differential access to social determinants of health. Healthcare services that respond to this variability are needed to achieve the highest attainable health for all.