Throughout the COVID-19 pandemic, Black children have been significantly more likely than White children to require intensive care, develop inflammatory syndromes, and experience other severe post-COVID complications, according to a new systematic review and meta-analysis published in BMC Infectious Diseases.
For the review, a team led by researchers at UTHealth Houston School of Public Health in Dallas looked at data from 31 studies published from 2020 to 2024 that examined racial and ethnic disparities in pediatric long COVID, multisystem inflammatory syndrome in children (MIS-C), and pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS).
Together, the studies included children from the United States, Switzerland, the United Kingdom, Ecuador, Spain, France, Brazil, and Ireland.
Black kids had double the odds of ICU admission
Compared with White children, Black children had nearly double the odds of intensive care unit (ICU) admission (odds ratio [OR], 1.89) and were more than twice as likely to develop MIS-C (OR, 2.37). Black children also had markedly higher odds of developing PIMS-TS, a rare and potentially life-threatening hyperinflammatory condition (OR, 16.28).
While Hispanic children appeared somewhat less likely to develop severe MIS-C, their overall MIS-C incidence remained higher than that of White children (OR, 2.70). The findings also showed elevated risks of MIS-C death among Asian/Pacific Islander (OR, 6.79) and American Indian/Alaska Native children (OR, 4.07), although these figures had wide confidence intervals, indicating imprecision.
Long-COVID findings were less clear. Black and mixed-race children were likely to report persistent symptoms, but the findings were not statistically significant, while PIMS-TS was shown to disproportionately affect minority children across all the studies in the review.
The disparities likely reflect broader structural inequities that shaped the pandemic and highlight the need for more equitable healthcare strategies.
The researchers said the disparities likely reflect broader structural inequities that shaped the pandemic and highlight the need for more equitable healthcare strategies.
“These findings align with adult studies, which also reveal disparities in Long COVID outcomes, and underscore the urgent need for targeted interventions to address the disproportionate burden of post-COVID conditions in minority groups,” they write. “Ensuring equitable access to healthcare and early management strategies is critical to mitigating these disparities.”
