Chapter 10 300 SUMMARY IN ENGLISH Epidemiology and long-term clinical characteristics of COVID-19 in Amsterdam, the Netherlands: Lessons learned and considerations for the future This thesis assessed the epidemiology of coronavirus disease 2019 (COVID-19) in Amsterdam-Amstelland, the Netherlands, and conducts an in-depth analysis of the longterm consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in adults. Chapter 1 presents key epidemiological features of the COVID-19 pandemic, as evidenced in the Netherlands, reflected against worldwide knowledge, and introduces core concepts regarding ‘long COVID’, the term describing the heterogeneous condition of long-term sequelae of COVID-19. In addition, this initial chapter provides an overview of the aims of this thesis and the sources of data used. In Part 1 of this thesis, the epidemiology of COVID-19 in Amsterdam-Amstelland and an overview of the long-term consequences of COVID-19 are discussed. During the first months of the pandemic in the Netherlands, clinicians in tertiary care signaled that a disproportionate number of hospitalised patients with COVID-19 had a migration background. To evaluate these observations, Chapter 2 and Chapter 3 assess differences in burden of disease between socio-demographic groups by comparing the rate of COVID-19 hospitalisation according to city district (as a proxy marker for socio-economic status [SES]; categorized as peripheral [lower SES] versus central [higher SES] districts) and migration background (defined as ethnic-Dutch, Western/European migration background and non-Western/European migration background). Chapter 2 focuses on the first wave of COVID-19 in Amsterdam-Amstelland (27 February to 1 June 2020), whilst Chapter 3 evaluates the second wave, encompassing the remainder of the COVID-19 pre-vaccination period (1 June 2020 to 20 January 2021). During both the first and second wave, individuals living in peripheral (lower SES) city districts were almost twice as likely to be hospitalised for COVID-19 compared to individuals living in central city districts (higher SES). In addition, during the first COVID-19 wave, the frequency at which individuals with a non-Western/European migration background were hospitalised with COVID-19 was more than double that of ethnic-Dutch individuals, when standardizing for age and sex. However, in the second wave, the standardised rate of COVID-19 hospitalisation for nonWestern/European increased to 4.5 times that of ethnic-Dutch individuals. Throughout the pre-vaccination period, city district and migration background were found to be independent determinants of COVID-19 hospitalisation. Similar disparities have been observed in other high-income countries (HICs) including the United Kingdom, Norway
RkJQdWJsaXNoZXIy MTk4NDMw