Variation in clinical presentation, complications and outcomes for Māori and Pacific peoples among hospitalised adults with COVID-19 in 2022, Aotearoa New Zealand

Michael J Maze; Haylea Rodgers; Jonathan Williman; Rebekah Anstey; Emma Best; Hasan Bhally; Aliya Bryce; Catherina Chang; Kevin Chen; Jack Dummer; Michael Epton; William Good; Jennifer Goodson; Corina Grey; Kate Grimwade; Robert J Hancox; Redzuan Hassan; Thomas Hills; Sandra Hotu; Colin McArthur; Susan Morpeth; David R Murdoch; Fiona Pease; Romana Pylypchuk; Nigel Raymond; Stephen Ritchie; Deborah Ryan; Vanessa Selak; Malina Storer; Tony Walls; Rachel Webb; Conroy Wong; Karen Wright

doi:10.1111/imj.70114

Variation in clinical presentation, complications and outcomes for Māori and Pacific peoples among hospitalised adults with COVID-19 in 2022, Aotearoa New Zealand

Intern Med J. 2025 Jun 21. doi: 10.1111/imj.70114. Online ahead of print.

Authors

Michael J Maze¹, Haylea Rodgers¹, Jonathan Williman², Rebekah Anstey³, Emma Best⁴, Hasan Bhally⁵, Aliya Bryce⁵, Catherina Chang³, Kevin Chen⁶, Jack Dummer¹, Michael Epton⁷, William Good⁸, Jennifer Goodson⁶, Corina Grey⁹, Kate Grimwade⁶, Robert J Hancox^{3

10}, Redzuan Hassan⁵, Thomas Hills^{11

12}, Sandra Hotu¹³, Colin McArthur¹⁴, Susan Morpeth¹⁵, David R Murdoch¹⁶, Fiona Pease³, Romana Pylypchuk¹⁷, Nigel Raymond¹⁸, Stephen Ritchie¹¹, Deborah Ryan¹⁹, Vanessa Selak¹⁷, Malina Storer⁷, Tony Walls²⁰, Rachel Webb⁴, Conroy Wong^{8

21}, Karen Wright²²

Affiliations

¹ Department of Medicine, University of Otago, Christchurch, New Zealand.
² Department of Population Health, University of Otago, Christchurch, New Zealand.
³ Respiratory Department, Te Whatu Ora Waikato, Hamilton, New Zealand.
⁴ Department of Paediatrics, University of Auckland, Auckland, New Zealand.
⁵ Infectious Diseases Department, Te Whatu Ora Waitematā, Auckland, New Zealand.
⁶ Infectious Diseases Department, Te Whatu Ora Hauora a Toi Bay of Plenty, Tauranga, New Zealand.
⁷ Respiratory Department, Te Whatu Ora Waitaha Canterbury, Christchurch, New Zealand.
⁸ Respiratory Department, Te Whatu Ora Counties Manukau, Auckland, New Zealand.
⁹ Department of General Practice and Primary Healthcare, University of Auckland, Auckland, New Zealand.
¹⁰ Department of Preventive and Social Medicine, University of Otago, Christchurch, New Zealand.
¹¹ Department of Infectious Diseases, Te Whatu Ora Auckland, Auckland, New Zealand.
¹² Medical Research Institute of New Zealand, Wellington, New Zealand.
¹³ Respiratory Medicine Department, Te Whatu Ora Auckland, Auckland, New Zealand.
¹⁴ Department of Critical Care Medicine, Te Whatu Ora Auckland, Auckland, New Zealand.
¹⁵ Department of Infectious Diseases, Te Whatu Ora Counties Manukau, Auckland, New Zealand.
¹⁶ Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand.
¹⁷ Department of Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand.
¹⁸ Infection Service, Te Whatu Ora Capital, Coast and Hutt Valley, Newtown, New Zealand.
¹⁹ Pacific Perspectives, Wellington, New Zealand.
²⁰ Department of Paediatrics, University of Otago, Christchurch, New Zealand.
²¹ Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
²² Te Kupenga Hauora Māori, University of Auckland, Auckland, New Zealand.

PMID: 40543063
DOI: 10.1111/imj.70114

Abstract

Background: Pacific region-specific data on the clinical course of COVID-19 are limited. We aimed to describe clinical features and outcomes from Aotearoa New Zealand patients, focusing on Māori and Pacific peoples.

Methods: We conducted a retrospective cohort study among adults (≥16 years) hospitalised due to COVID-19 at 11 hospitals from January to May 2022. We included all Māori and Pacific patients and every second non-Māori, non-Pacific (NMNP) patient using data from chart review and national datasets.

Results: Of 2319 patients, 582 (25%) were Māori, 914 (39%) Pacific peoples and 862 NMNP (median age 52, 57 and 63 years respectively). Vaccination coverage (≥2 doses) was 73.4% (n = 437) for Māori, 76.7% (n = 701) for Pacific peoples (n = 701) and 84.8% (n = 731) for NMNP. Among 832 (35.9%) with complications, Māori had a greater risk than NMNP of acute kidney injury (risk ratio (RR) 1.87, P < 0.001), cardiac arrhythmia (RR = 1.60, P = 0.023), shock (RR = 2.64, P = 0.005), myocardial infarction (RR 2.21, P = 0.042), cardiac arrest (RR 2.68, P = 0.046) and acute respiratory distress syndrome (RR = 2.81, P = 0.008). Pacific patients experienced a greater risk than NMNP of acute kidney injury (RR = 2.18, P < 0.001) and pneumonia (RR = 1.32, P = 0.047) and a lower risk of thromboembolism (RR = 0.35, P = 0.004) and myocarditis/pericarditis (RR = 0.23, P = 0.003). During admission, 23 (3.3%) Māori, 36 (3.9%) Pacific and 28 (3.2%) NMNP patients died, with no difference in age-standardised mortality.

Conclusions: The clinical course of patients hospitalised by COVID-19 varied between ethnic groups, likely reflecting differential access to social determinants of health. Healthcare services that respond to this variability are needed to achieve the highest attainable health for all.

Keywords: COVID‐19; New Zealand; Pacific; indigenous health.

Grants and funding

Ministry of Health, New Zealand