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Do racial health disparities play out in long COVID? These health researchers are trying to find out

The COVID-19 pandemic hit Northeast Ohio’s Black community especially hard, recent research shows. Now researchers from the National Institute of Health (NIH) are trying to determine whether long COVID-19 will also disproportionately affect Black people.

“We know that minorities suffer more from acute COVID so when they have it, they seem to die more from it and have more serious disease,” said Grace McComsey, a researcher at University Hospitals (UH), who is involved in the NIH study. “We don't know yet for long COVID.”

It’s a question that hits close to home for Yvonka Hall, the executive director of the Northeast Ohio Black Health Coalition (NEOBHC). Even as her organization continues to offer free vaccination clinics and health fairs, Hall said she herself is struggling with the effects of long COVID.

“COVID-19 was like playing ping-pong with my body,” Hall said.

The pandemic especially afflicted communities of color because many suffer from underlying health conditions like high blood pressure, diabetes, heart disease and obesity, said Dr. Charles Modlin, the director of Metrohealth’s Office of Inclusion, Diversity and Equity.

Many researchers believe that the increased prevalence of those conditions in certain communities is related to social determinants of health like access to fresh food, good transportation and a healthy environment play a role.

“Where I practice, I know about food deserts. I know about the lack of access to care. I know about transportation issues. I know patients that go to work sick because they're the only breadwinners,” said Dr. Carla Harwell, the medical director at the Otis Moss Jr. Medical Center, who practices in Cleveland's Fairfax neighborhood.

McComsey said she wants to better understand how that reality affects long COVID. She is a researcher for the NIH’s Researching COVID To Enhance Recovery (RECOVER) study, which is currently enrolling 17,000 people across the country. So far, 1,050 Northeast Ohio residents, who either have long COVID or suffered from a previous COVID-19 infection but currently have no symptoms, have enrolled in the first phase — 35% are African American, McComsey said.

During the first phase of the study, which will last four years, researchers will observe who is suffering from long COVID and how it is affecting them. Currently, researchers are in the process of sorting long-COVID patients into categories, said Dr. Nora G. Singer, a rheumatologist at Metrohealth.

“Then we're studying how did COVID cause those symptoms,” she said.

It is very important to enroll enough minorities in the study to understand how long COVID affects different people of different races and ethnicities, said McComsey.

“That's why we're focusing so much on enrolling enough African Americans, enough Hispanics and other groups as well, to make it really a diverse study,” she said.

Building trust in communities of color is key to creating a diverse study, she said.

Rev. Tony Minor, a faith-based coordinator in Cleveland for the RECOVER study, said he thinks the level of trust between medical systems and communities of color and other vulnerable populations is improving.

“The issue is how Black and brown patients have felt during medical treatments,” he said. “There are times they run into people that are impatient with them and have biases [and] appear to not care.”

McComsey said UH is trying to be more visible in communities that do not normally come to them to participate in studies. The system has deployed a mobile research unit to bring the lab to the people, she said.

During the clinical phase of the study, which will be the second phase, researchers will evaluate the medical treatments available for long COVID. In the U.S., only between four and seven percent of those enrolled in clinical trials are minorities, according to McComsey.

“That's not acceptable,” said McComsey.

Minor said the recruitment efforts for phase one make him optimistic. Agencies, churches, pastors and community activists have stepped up to recruit people of color for RECOVER, he said. “They've done all that they could do to try to get people to respond, and I think those are really good things,” Minor said.

Partnerships are important, but funding for grassroots organizations embedded in communities really matters when it comes to convincing people of color to participate, said Hall, of the Northeast Ohio Black Health Coalition.

“We need to do everything that we can to make sure that equity is around funding, engagement and access,” she said.

Corrected: February 17, 2023 at 8:56 AM EST
Due to a reporter error, a previous version of this story misstated the number of Northeast Ohio residents who enrolled in the first phase of the study. The correct number is 1,050. We regret the error.