COVID-19 disease severity in language minorities in Finland: an observational population-based register study

Abstract Background Migrants and ethnic minority populations appear to have experienced a disproportionate burden of the coronavirus disease 2019 (COVID-19) pandemic. In Finland, a foreign first language is often considered an indicator of foreign ethnicity. We investigated whether hospitalized pati...

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Main Authors: Juulia Pynnönen, Heli Salmi, Mitja Lääperi, Anu Kantele, Ville Holmberg
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23160-x
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author Juulia Pynnönen
Heli Salmi
Mitja Lääperi
Anu Kantele
Ville Holmberg
author_facet Juulia Pynnönen
Heli Salmi
Mitja Lääperi
Anu Kantele
Ville Holmberg
author_sort Juulia Pynnönen
collection DOAJ
description Abstract Background Migrants and ethnic minority populations appear to have experienced a disproportionate burden of the coronavirus disease 2019 (COVID-19) pandemic. In Finland, a foreign first language is often considered an indicator of foreign ethnicity. We investigated whether hospitalized patients with a foreign first language presented with a more severe COVID-19 upon admission to specialized health care, and if they had a similar in-hospital course of disease compared with those with a domestic first language. Methods We conducted a retrospective observational population-based register study, including all patients with confirmed COVID-19 infection admitted to specialized health care and intensive care units (ICUs) in the capital province of Finland between 27 February and 3 August 2020. We examined first values, peak values, and changes in laboratory parameter elevation during hospitalization among different language groups. Studied biomarkers included creatinine, alanine aminotransferase (ALAT), fibrin D-dimer, leukocyte count, thrombocytes, C-reactive protein (CRP), and lactate dehydrogenase (LDH). Results First language was registered for 614 (94.9%) patients admitted to specialist care, of whom 131 (21.3%) had a foreign first language. Those with a foreign first language were younger (median 49, IQR 36.5–57, versus 62, 50–75.5, years, p < 0.001) and exhibited smaller changes in CRP (22.5, IQR 0–104.75 versus 52, IQR 7.25–125, p = 0.031). After adjustment for age and sex, none of the differences remained significant. A foreign first language did not impact the risk of ICU admission (20.1% versus 21.4%, p = 0.81). Peak leukocyte count, change in leukocyte count, and all CRP variables were the most significant indicators of ICU admission (p < 0.001 for all) and behaved similarly across language groups. Conclusions CRP and leukocyte count were the most reliable indicators of more severe COVID-19 disease presentation and ICU admission. Although those with a foreign first language were overrepresented in COVID-19 related hospitalizations, we found no significant differences in laboratory findings based on first language, implying that disease severity among hospitalized patients did not differ between language minorities and the rest of the population.
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spelling doaj-art-9deeb8faf8744f5e8824ef5ba46270852025-08-20T02:38:31ZengBMCBMC Public Health1471-24582025-05-0125111010.1186/s12889-025-23160-xCOVID-19 disease severity in language minorities in Finland: an observational population-based register studyJuulia Pynnönen0Heli Salmi1Mitja Lääperi2Anu Kantele3Ville Holmberg4Department of Infectious Diseases, University of Helsinki and Helsinki University HospitalDepartment of Anaesthesia and Intensive Care, University of Helsinki and Helsinki University HospitalDepartment of Infectious Diseases, University of Helsinki and Helsinki University HospitalDepartment of Infectious Diseases, University of Helsinki and Helsinki University HospitalDepartment of Infectious Diseases, University of Helsinki and Helsinki University HospitalAbstract Background Migrants and ethnic minority populations appear to have experienced a disproportionate burden of the coronavirus disease 2019 (COVID-19) pandemic. In Finland, a foreign first language is often considered an indicator of foreign ethnicity. We investigated whether hospitalized patients with a foreign first language presented with a more severe COVID-19 upon admission to specialized health care, and if they had a similar in-hospital course of disease compared with those with a domestic first language. Methods We conducted a retrospective observational population-based register study, including all patients with confirmed COVID-19 infection admitted to specialized health care and intensive care units (ICUs) in the capital province of Finland between 27 February and 3 August 2020. We examined first values, peak values, and changes in laboratory parameter elevation during hospitalization among different language groups. Studied biomarkers included creatinine, alanine aminotransferase (ALAT), fibrin D-dimer, leukocyte count, thrombocytes, C-reactive protein (CRP), and lactate dehydrogenase (LDH). Results First language was registered for 614 (94.9%) patients admitted to specialist care, of whom 131 (21.3%) had a foreign first language. Those with a foreign first language were younger (median 49, IQR 36.5–57, versus 62, 50–75.5, years, p < 0.001) and exhibited smaller changes in CRP (22.5, IQR 0–104.75 versus 52, IQR 7.25–125, p = 0.031). After adjustment for age and sex, none of the differences remained significant. A foreign first language did not impact the risk of ICU admission (20.1% versus 21.4%, p = 0.81). Peak leukocyte count, change in leukocyte count, and all CRP variables were the most significant indicators of ICU admission (p < 0.001 for all) and behaved similarly across language groups. Conclusions CRP and leukocyte count were the most reliable indicators of more severe COVID-19 disease presentation and ICU admission. Although those with a foreign first language were overrepresented in COVID-19 related hospitalizations, we found no significant differences in laboratory findings based on first language, implying that disease severity among hospitalized patients did not differ between language minorities and the rest of the population.https://doi.org/10.1186/s12889-025-23160-xCOVID-19EthnicityLanguageMigrantMinoritySARS-CoV-2
spellingShingle Juulia Pynnönen
Heli Salmi
Mitja Lääperi
Anu Kantele
Ville Holmberg
COVID-19 disease severity in language minorities in Finland: an observational population-based register study
BMC Public Health
COVID-19
Ethnicity
Language
Migrant
Minority
SARS-CoV-2
title COVID-19 disease severity in language minorities in Finland: an observational population-based register study
title_full COVID-19 disease severity in language minorities in Finland: an observational population-based register study
title_fullStr COVID-19 disease severity in language minorities in Finland: an observational population-based register study
title_full_unstemmed COVID-19 disease severity in language minorities in Finland: an observational population-based register study
title_short COVID-19 disease severity in language minorities in Finland: an observational population-based register study
title_sort covid 19 disease severity in language minorities in finland an observational population based register study
topic COVID-19
Ethnicity
Language
Migrant
Minority
SARS-CoV-2
url https://doi.org/10.1186/s12889-025-23160-x
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AT mitjalaaperi covid19diseaseseverityinlanguageminoritiesinfinlandanobservationalpopulationbasedregisterstudy
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