COVID-19 Health Care for Afghan Refugees as a Minor Ethnicity in Iran: Clinical Differences and Racial Equality in Health

Abstract

The aim of this research was to look at the clinical differences between Afghan refugees and the Iranian community, as well as the evaluation of healthcare inequalities against Afghan refugees. ‎This was a 1:2 matched case-control study carried out at two tertiary hospitals of Jahrom city, southern Iran, from January 2020 to December 2020. Cases were COVID-19 infected Afghans, and controls were Iranian patients. Demographic data, Self-reported symptoms, disease history, and initial symptom to referral length were extracted from medical records. CT scans being conducted and receiving ICU treatment were assessed for evaluation of racial inequality in health care. In this study, 132 Afghan refugees were compared to 266 Iranian controls. There were multiple self-reported symptoms being statistically differently manifested in Afghan refugees in comparison to Iranian COVID-19 patients. There was no difference in probability of being evaluated by HRCT or receiving ICU treatment (P=0.173, 1, respectively) even after being adjusted for symptoms or co-morbidities that were manifesting differently between Afghan vs. Iranian patients (P=0.476, 0.881, respectively). Ten (7.57%) subjects died in the case group and 18 (6.76) in the control group. There wasn’t any significant difference in the death rate between the groups (P=0.766). Our study revealed huge differences in symptoms of Afghan vs. Iranian COVID-19 patients, while these differences did not affect the probability of receiving proper health care. Jahrom city was a case of equality in COVID-19 health care toward the ethnic minorities.