Profile of COVID-19 Symptomatology and Its Correlates Among Non-Citizens, Predominately Seeking Asylum, Released By Federal Immigration Authorities

Background

The COVID-19 pandemic has presented significant obstacles for non-citizens seeking asylum at the United States' southern border. (U.S.). Due to the "wait in Mexico" policy, such as Title 42, asylum seekers who arrived in the United States were not permitted to enter the country on public health ground. There is a lack of estimates of prevalence of COVID-19 in this group and the correlates associated with the risk. Studies conducted with other non-asylum seekers found demographic and socio-economic attributes as well as attitude toward mitigating behaviors for COVID-19. The purpose of this study was to document prevalence of and correlated with COVID-19-like symptoms among non-citizens predominately asylum seekers who are released by federal immigration authorities.

Methods

The recruitment of participants was conducted in a temporary shelter located in the outskirt of downtown Phoenix, Arizona. The study team included research staff and bilingual Spanish-speaking community health workers who hosted non-citizens released by the federal immigration agency. The participants were offered a saliva-based COVID-19 test and a survey that included a measure of twelve symptoms frequently observed after COVID-19 infection. We measured knowledge and attitude toward COVID-19 risk mitigating behaviors health behaviors and a tool for economic challenges during the pandemic. Age, gender, race and ethnicity, educational attainment, English proficiency, and being an asylum seeker are additional covariates. Multiple imputation assisted in addressing missing values of covariates and data of health behaviors, resulting in 468 cases being analyzed for this study as opposed to 347 cases if listwise deletion had been utilized. Using SPSS version 28.0 and an alpha value of 0.05, we performed logistic regression analyses on twenty multiple imputed data sets.

Results:

A fourth reported any COVID-19 symptoms. 53.3% of 468 respondents were female, 94.0% were pursuing asylum, 55.2% identified as Latinx, while non-Latinx Whites and other races made up 27.7% and 17.2%, respectively. 42.7% had a college degree or higher, followed by 32.1% with a high school diploma and 25.0% with less than a high school diploma. The median age was 33.1 years. As for particular COVID-19 symptoms prevalence, 14.1%, 7.9%, and 7.1% reported headache, muscle or body pains, and cough, respectively, most frequently observed. Adjusted analysis discovered that females (OR=1.79) and Latinx compared to non-Latinx Whites (OR=1.75) were more likely to report any COVID-19 symptoms. Health behaviors such as knowledge of COVID-19 risk behaviors and attitude toward mask-wearing and economic challenges during the pandemic were not significantly associated with the likelihood of reporting COVID-19 symptoms.

Conclusion and Implications:

The study found that a fourth of respondents reported any symptoms of COVID-19 among non-citizens predominately seeking asylum who were released by federal immigration authority passing security vetting. Our findings suggest that Latinx and female asylum seekers are more likely to be family-unit migrants, which increases the epidemiological risks that this vulnerable group endures through migration during the COVID-19 pandemic. Social workers should advocate for policies and programs that addresses structural barriers contributing to their limited access to resources mitigating the risk of COVID-19 infection.