The Institute for Translational Medicine (ITM) awarded a nearly $30,000 grant to Advocate Health Care researchers to explore the possible underdiagnosis of Long COVID in Chicago’s Black community.
The funds will be used for a research project that aims to determine whether historical inequities in the health care system are resulting in a miscount of Black individuals with Long COVID.
“Since the start of the COVID-19 pandemic, researchers have documented racial inequities in COVID infections, severe acute illness once infected and deaths from COVID, with Black communities being hit harder than white communities,” said Research Scientist Jana Hirschtick, PhD, MPH, Advocate Aurora Research Institute’s lead investigator for the project. “But there is not clear evidence that Black individuals are suffering from Long COVID at higher rates than white individuals. In fact, there is preliminary evidence that most patients receiving a formal Long COVID diagnosis are white. This doesn’t make intuitive sense, given that severe COVID illness is a strong predictor of Long COVID and has been more prevalent among Black individuals throughout the pandemic. Something isn’t adding up.”
Advocate researchers suggest that the known differences in death rates between Black individuals and white individuals from an initial COVID infection do not fully explain the differences in rates of Long COVID diagnosis between the two groups.
Instead, the researchers suspect there is an under-identification of Long COVID among Black individuals resulting from a lack of Long COVID awareness, barriers to care that could lead to a Long COVID diagnosis, and discrimination toward Black individuals in health care settings.
“It’s possible that Black individuals may not attribute their longer-lasting symptoms to their initial COVID illness, or that they didn’t know they had an initial COVID illness, since Black communities had lower access to testing centers in the initial stages of the pandemic,” said Ebenezer Nii Teiko Hammond, a Community Leader for the project.
“Historical barriers to care may also contribute to underdiagnosis of Long COVID in the Black community,” added Denise Henley, another Community Leader for the project. “There is no reliable diagnostic test for Long COVID currently. This means that it often requires repeat visits to the doctor to rule out other conditions. The lack of a Long COVID test also means Black people must rely on doctors to believe their description of symptoms, a part of health care that has been historically fraught with discrimination.”
The project aims to start investigating these hypotheses by utilizing a community-based participatory research approach to developing research questions. By relying on community members, along with doctors and public health researchers, the team hopes to generate more relevant research questions than any one of these groups would generate on their own.
The researchers will then analyze Advocate’s electronic health records to answer these questions.
The research project is expected to launch before the end of 2023 and complete by the middle of 2024.
“As an organization, we are committed to identifying and addressing health inequities,” said Denise Angst, PhD, RN, Vice President of Academic Research and Strategic Partnerships for the Research Institute and leader of ITM-Advocate Aurora Health. “With our large and diverse health system, we have the opportunity to begin to further understand the inequities related to Long COVID and initiate actions to ensure our patients are identified and receive beneficial treatments. Furthermore, with the National Institutes of Health devoting more than $1 billion to identifying Long COVID treatments and with Long COVID now a federally qualified disability, more accurate identification will help ensure these treatments are accessible to those in need.”
This project is supported by the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) that supports the Institute for Translational Medicine (ITM) through Grant Number UL1TR002389. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
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