Journal article
Black Patients Underdiagnosed With Long COVID In The US Compared With White Patients
Health affairs (Millwood, Va.), Vol.45(7), pp.775-781
07/2026
DOI: 10.1377/hlthaff.2025.00179
PMID: 42413051
Abstract
Long COVID has debilitating effects but is inconsistently diagnosed because of subjective criteria, limited treatments, and variations in health care access. We analyzed electronic health records from the National Clinical Cohort Collaborative for patients diagnosed with acute COVID-19 in the US between January 2022 and March 2023. Using six race and ethnicity categories, we evaluated 222 symptoms and long COVID diagnoses (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, code U09.9) within twelve months after infection. We assessed the relationship between race and ethnicity and long COVID diagnosis, adjusting for patient covariates and long COVID symptomatology set to the presence of at least one documented long COVID-associated symptom. Among 2.4 million patients, Black patients were less likely to be diagnosed with long COVID than White patients under a scenario in which a symptom was present and health care monitoring was at least bimonthly. For the remaining racial and ethnic groups, we found no statistically significant differences in long COVID diagnoses compared with White patients. Although the magnitude was small, the difference in diagnosis likelihood suggests the presence of potential diagnostic bias.
Details
- Title: Subtitle
- Black Patients Underdiagnosed With Long COVID In The US Compared With White Patients
- Creators
- Zachary Butzin-Dozier - Stanford MedicineYunwen Ji - University of California, BerkeleySarang Deshpande - University of California, BerkeleyA Jerrod Anzalone - University of Nebraska at OmahaLin-Chiun Wang - University of California, BerkeleyEric Hurwitz - University of North Carolina at Chapel HillManav Kumar - University of California, BerkeleyRena C Patel - University of Alabama at BirminghamJing Sun - Johns Hopkins UniversityMcKaylee Robertson - Robertson FoundationAndrew Mertens - University of California, BerkeleyMarlene Camacho-Rivera - SUNY Downstate Health Sciences UniversityJohn M Colford - University of California, BerkeleyAlan E Hubbard - University of California, BerkeleyCharisse Madlock-Brown - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Health affairs (Millwood, Va.), Vol.45(7), pp.775-781
- DOI
- 10.1377/hlthaff.2025.00179
- PMID
- 42413051
- ISSN
- 2694-233X
- eISSN
- 2694-233X
- Publisher
- Health Affairs Publishing LLC
- Grant note
- Bill & Melinda Gates Foundation: OPP11 65144 National Institute of Mental Health, National Institutes of Health: R01131 542 National Institute of General Medical Sciences, National Institutes of Health: U54 GM11 5458
This research was financially supported by a global development grant (Grant No. OPP11 65144) from the Bill & Melinda Gates Foundation to the University of California Berkeley. Individual authors were supported by the following funding sources: National Institute of Mental Health, National Institutes of Health (Grant No. R01131 542; principal investigator: Rena C. Patel); and support for Jerrod Anzalone by the National Institute of General Medical Sciences, National Institutes of Health (Grant No. U54 GM11 5458) , which funds the Great Plains IDeA-CTR Network at University of Nebraska Medical Center, in Omaha, Nebraska. The authors thank Christopher G. Chute for his contributions to the manuscript. Zachary Butzin-Dozier was at the University of California Berkeley when this work was performed. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Author disclosures are available online in the article's supplemental materials.
- Language
- English
- Date published
- 07/2026
- Academic Unit
- Nursing
- Record Identifier
- 9985180940302771
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