Greater Risk of Poor COVID-19 Outcomes in Minority Ethnic Groups in England

Priscilla Lynch 

May 04, 2021

Minority Ethnic groups had a higher risk of testing positive for SARS-CoV-2 and of COVID-19-related hospitalisations, intensive care unit (ICU) admissions and death compared with White groups in England, according to an observational cohort study published in  The Lancet.

The researchers used the new secure OpenSAFELY data analytics platform to analyse (using adjusted multivariable Cox regression) partially anonymised electronic health data collected by GPs covering 40% of England. These GP records were linked to other national coronavirus-related data sets for the first and second waves of the pandemic—including testing, hospital data and mortality records.

Of 17,288,532 adults included in the study, 62.9 per cent (10,877,978) were White; 5.9 per cent (1,025,319) South Asian; 2 per cent (340,912) Black; 1.9 per cent (320,788) other; and 1 per cent (170,484) mixed. Ethnicity was unknown for 26.3 per cent (4,553,051) people.

During wave 1, nearly all minority ethnic groups had a higher relative risk for testing positive, hospitalisation, ICU admission and death compared with White groups.

The largest disparities were seen in ICU admissions, which were more than doubled for all minority ethnic groups compared with White groups, with Black people more than three times more likely to be admitted to ICU after accounting for other factors.

The proportion of people testing positive for SARS-CoV-2 in wave 1 was higher in South Asian groups (0.9% test positivity), Black (0.7%) and mixed groups (0.5%) compared with White people (0.4%). 

In wave 2, the risks of hospitalisation, ICU admission and death relative to the White group were increased in the South Asian group but attenuated for the Black group compared with these risks in wave 1.

Disaggregation into 16 ethnicity groups showed important heterogeneity within the five broader categories.

“To improve COVID-19 outcomes, we urgently need to tackle the wider disadvantage and structural racism faced by these communities, as well as improving access to care and reducing transmission,” said lead author Dr Rohini Mathur.

Mathur R, Rentsch CT, Morton CE, Hulme WJ, Schultze A, MacKenna B, Eggo RM, Bhaskaran K, Wong AYS, Williamson EJ, Forbes H, Wing K, McDonald HI, Bates C, Bacon S, Walker AJ, Evans D, Inglesby P, Mehrkar A, Curtis HJ, DeVito NJ, Croker R, Drysdale H, Cockburn J, Parry J, Hester F, Harper S, Douglas IJ, Tomlinson L, Evans SJW, Grieve R, Harrison D, Rowan K, Khunti K, Chaturvedi N, Smeeth L, Goldacre B; OpenSAFELY Collaborative. Ethnic differences in SARS-CoV-2 infection and COVID-19- related hospitalisation, intensive care unit admission, and death in 17 million adults in England: an observational cohort study using the OpenSAFELY platform. Lancet. 2021 Apr 30 [Epub ahead of print]. doi: 10.1016/S0140-6736(21)00634-6.

This article originally appeared on Univadis, part of the Medscape Professional Network.

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