| Summary: | Background: Severe acute respiratory syndrome due to Coronavirus-2 (SARS-CoV-2) remains a global public health concern. Demographic and medical factors like vaccination status have been reported to influence the disease burden and outcome. Indigenous populations have been reported to be disproportionately affected by COVID -19; however, the impact of COVID-19 on Indigenous people in Canada remains understudied. The objectives of the study are to: 1) describe the characteristics of COVID-19 cases among on-reserve northern Saskatchewan First Nations people for the period March 2020 to December 2022; and 2) determine the association of demographic and medical factors with various indicators of COVID-19 severity and outcomes. Methods: We accessed de-identified data of 8,428 laboratory-confirmed COVID-19 cases during the period March 2020–December 2022. We conducted univariate, bivariate, and multivariate analyses to describe COVID-19 in this population and to determine the of association between various characteristics and COVID-19 severity. Characteristics of interest were demographic, clinical, and vaccine related. Three indicators of severity were included: hospitalization, admittance to an intensive care unit, and death. Results: Even though they account for <5% of the population, northern Saskatchewan First Nations on-reserve reported 5.6% of the total number of COVID-19 cases in the province. Over 90% of cases were under 65 years old. More than 53% of cases had no COVID-19 vaccination history at the time of infection. The most common clinical symptoms reported among COVID-19 patients in the study were cough, fever, loss of taste, and loss of smell. We observed that people 65 years and older were more likely to be hospitalized with severe COVID-19, despite having less than 10% of the infection rate of younger individuals. This finding is similar to other studies in Canada and other parts of the world. More hospitalization and deaths were associated with males than females. Hospitalization, ICU admission, and ...
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