Work

Burden of chronic diseases in migrant workers (MW) in Singapore and impact on COVID-19: A large single-centre cohort study during the peak MW 2020 outbreak

Year: 2025

Type: article

Abstract: • A high proportion of chronic diseases amongst migrant workers were newly diagnosed. • Charlson’s score ≥ 1 was associated with higher odds of moderate-severe COVID-19. • The study highlights health disparities that should be addressed by health policies. The COVID-19 pandemic unmasked systemic inequities amongst migrants globally. In Singapore, dormitory residing migrant workers (MWs) were disproportionately impacted accounting for over 54,500 COVID-19 cases (93% of all cases) in 2020. Their limited health insurance did not cover outpatient acute or chronic illness care. There is a lack of systematic data on the chronic disease prevalence amongst MWs. In this cohort study, we analysed the electronic medical data of all MWs with PCR-confirmed symptomatic COVID-19 admitted to the National Centre for Infectious Diseases (NCID), Singapore from 1 st to 30 th April 2020, the peak of the MW outbreak. We aimed to ascertain the prevalence of chronic diseases and their impact on COVID-19 disease severity. 2,498 male MWs were included. Majority (>90%) were of South Asian origin. Median age was 34 years (IQR 29-40). 247 (9.9%) had at least one chronic disease; 99 (4.0%) had diabetes mellitus (22 (22.2%) newly diagnosed), 69 (2.8%) had dyslipidaemia (26 (37.7%) newly diagnosed), and 135 (5.4%) had hypertension (21 (15.5%) newly diagnosed). While 278 (11.1%) had pneumonia, only 16 (0.6%) required oxygen or intensive/high-dependency care, with no mortality. Charlson’s score ≥ 1 (compared to 0) was associated with 80% higher odds of moderate-severe COVID-19 outcome, aOR (adjusted odds ratio) 1.83 (1.16-2.90), P =0.01, adjusted for age and nationality in multivariable analyses. Although MWs had favourable COVID-19 medical outcomes during their acute illness, our study demonstrates a considerable burden of undiagnosed chronic diseases predisposing to cardiovascular disease and highlights health disparities that should be addressed by health policies.

Source: Journal of Migration and Health

DOI: 10.1016/j.jmh.2025.100365