Incidence and severe outcomes from COVID-19 among immigrant and minority ethnic groups and among groups of different socio-economic status: A systematic review
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Key message In this systematic review we have summarised and assessed available research from Norway and countries with similar welfare systems on the incidence of infection, rate of admission to hospital and death due to COVID-19. Populations of special interest were immigrants and minority ethnic groups as well as people with different socio-economic status. We included two studies from Norway (data up to November 2020), one study from Denmark (data up to September 2020) and nine studies from Sweden (data mainly up to May 2020). In Norway, the highest risk of COVID-19 infection (measured as Relative Risk Increase (RRI)), was among people born in Somalia, Pakistan, Iraq, Afghanistan and Turkey. In Denmark, the highest RRI of COVID-19 was among people born in Somalia, Pakistan, Morocco, Lebanon and Turkey. In Sweden, among people born in Turkey, Ethiopia, Somalia, Chile and Iraq. The occupational groups with the highest proportion of COVID-19 cases were different in the different waves of the pandemic. In the first wave in Norway, it was healthcare workers and drivers and in the second wave restaurant staff and tourist guides. In almost all occupational groups in Denmark, the proportion of COVID-19 infection was higher among people with non-Western origin than among people with Western and Danish origin. COVID-19 related admission to hospital occurred more often among people with non-Western origin in Norway and Denmark compared to those with Norwegian and Danish origin. In Sweden the risk for admission to hospital was higher for people who were not employed, for those who had to be present at work at least 50% of the time, and for people working in the health care system compared to those working from home. The number of COVID-19 related deaths in Norway and Denmark was too low to conclude about variation by country of birth. In Sweden, the results indicated that the risk of dying from COVID -19 was higher among people born in Low- or Middle-Income Countries compared to Swedish born. Also, a low socio-economic position, measured by education and net income, predicted an increased risk of death from COVID-19.