Differences in SARS-CoV-2 infections during the first and second wave of SARS-CoV-2 between six ethnic groups in Amsterdam, the Netherlands: A population-based longitudinal serological study

Liza Coyer; Anders Boyd; Janke Schinkel; Charles Agyemang; Henrike Galenkamp; Anitra D M Koopman; Tjalling Leenstra; Yvonne T H P van Duijnhoven; Eric P Moll van Charante; Bert-Jan H van den Born; Anja Lok; Arnoud Verhoeff; Aeilko H Zwinderman; Suzanne Jurriaans; Karien Stronks; Maria Prins

doi:10.1016/j.lanepe.2021.100284

Differences in SARS-CoV-2 infections during the first and second wave of SARS-CoV-2 between six ethnic groups in Amsterdam, the Netherlands: A population-based longitudinal serological study

Lancet Reg Health Eur. 2022 Feb:13:100284. doi: 10.1016/j.lanepe.2021.100284. Epub 2021 Dec 14.

Authors

Liza Coyer^{1

2}, Anders Boyd^{1

3}, Janke Schinkel⁴, Charles Agyemang⁵, Henrike Galenkamp⁵, Anitra D M Koopman⁵, Tjalling Leenstra¹, Yvonne T H P van Duijnhoven¹, Eric P Moll van Charante^{5

6}, Bert-Jan H van den Born^{5

7}, Anja Lok⁸, Arnoud Verhoeff^{9

1

10}, Aeilko H Zwinderman¹¹, Suzanne Jurriaans⁴, Karien Stronks⁵, Maria Prins^{1

2}

Affiliations

¹ Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, Netherlands.
² Amsterdam UMC, Department of Infectious Diseases, Amsterdam Infection and Immunity (AII), University of Amsterdam, Amsterdam, Netherlands.
³ Stichting HIV Monitoring, Amsterdam, Netherlands.
⁴ Amsterdam UMC, Department of Medical Microbiology, University of Amsterdam, Amsterdam, Netherlands.
⁵ Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands.
⁶ Amsterdam UMC, Department of General Practice, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands.
⁷ Amsterdam UMC, Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, Netherlands.
⁸ Amsterdam UMC, Department of Psychiatry, Amsterdam Public Health Research Institute, Center for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands.
⁹ Department of Epidemiology, Health Promotion & Healthcare Innovation, Public Health Service of Amsterdam, Amsterdam, Netherlands.
¹⁰ Department of Sociology, University of Amsterdam, Amsterdam, Netherlands.
¹¹ Amsterdam UMC, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, Amsterdam, Netherlands.

Abstract

Background: Surveillance data in high-income countries have reported more frequent SARS-CoV-2 diagnoses in ethnic minority groups. We examined the cumulative incidence of SARS-CoV-2 and its determinants in six ethnic groups in Amsterdam, the Netherlands.

Methods: We analysed participants enrolled in the population-based HELIUS cohort, who were tested for SARS-CoV-2-specific antibodies and answered COVID-19-related questions between June 24-October 9, 2020 (after the first wave) and November 23, 2020-March 31, 2021 (during the second wave). We modelled SARS-CoV-2 incidence from January 1, 2020-March 31, 2021 using Markov models adjusted for age and sex. We compared incidence between ethnic groups over time and identified determinants of incident infection within ethnic groups.

Findings: 2,497 participants were tested after the first wave; 2,083 (83·4%) were tested during the second wave. Median age at first visit was 54 years (interquartile range=44-61); 56·6% were female. Compared to Dutch-origin participants (15·9%), cumulative SARS-CoV-2 incidence was higher in participants of South-Asian Surinamese (25·0%; adjusted hazard ratio [aHR]=1·66; 95%CI=1·16-2·40), African Surinamese (28·9%, aHR=1·97; 95%CI=1·37-2·83), Turkish (37·0%; aHR=2·67; 95%CI=1·89-3·78), Moroccan (41·9%; aHR=3·13; 95%CI=2·22-4·42), and Ghanaian (64·6%; aHR=6·00; 95%CI=4·33-8·30) origin. Compared to those of Dutch origin, differences in incidence became wider during the second versus first wave for all ethnic minority groups (all p-values for interaction<0·05), except Ghanaians. Having household members with suspected SARS-CoV-2 infection, larger household size, and low health literacy were common determinants of SARS-CoV-2 incidence across groups.

Interpretation: SARS-CoV-2 incidence was higher in the largest ethnic minority groups of Amsterdam, particularly during the second wave. Prevention measures, including vaccination, should be encouraged in these groups.

Funding: ZonMw, Public Health Service of Amsterdam, Dutch Heart Foundation, European Union, European Fund for the Integration of non-EU immigrants.

Keywords: Antibody; COVID-19; Ethnicity; Incidence; Infection; SARS-CoV-2; Serology.