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
April 30, 2021
Rohini Mathur, PhD *, Christopher T Rentsch, PhD *, Caroline E Morton, MRCGP *, William J Hulme, PhD, Anna Schultze, PhD, Brian MacKenna, MPharm, Rosalind M Eggo, PhD, Prof Krishnan Bhaskaran, PhD, Angel Y S Wong, PhD, Prof Elizabeth J Williamson, PhD, Harriet Forbes, PhD, Kevin Wing, PhD, Helen I McDonald, PhD, Chris Bates, PhD, Seb Bacon, BA, Alex J Walker, PhD, David Evans, MPhil, Peter Inglesby, MPhil, Amir Mehrkar, MB, Helen J Curtis, DPhil, Nicholas J DeVito, MPH, Richard Croker, MSc, Henry Drysdale, MRCS, Jonathan Cockburn, BSc, John Parry, MRCGP, Frank Hester, BSc, Sam Harper, MSci, Prof Ian J Douglas, PhD, Laurie Tomlinson, PhD, Prof Stephen J W Evans, MSc, Prof Richard Grieve, PhD, David Harrison, PhD, Kathy Rowan, PhD, Prof Kamlesh Khunti, FMedSci, Prof Nishi Chaturvedi, MD, Prof Liam Smeeth, FMedSci †, Ben Goldacre, MRCPsych †.
Mathur et al conducted an observational study looking at death, intensive care unit admission, and COVID-19 related hospitalization and infection among different minority ethnic adult populations in the United Kingdom. The data was collected from the OpenSAFELY platform electronic health record system, and there were 17,288,532 adults that were observed in this study in two waves (February-August 2020 and September-December 2020). The hazard ratio for testing positive for infection was increased in South Asian people (1.08), Black people (1.08), and people of mixed ethnicities (1.04), compared to White populations. The “other” ethnicity category actually had a decrease in this hazard ratio (.77) compared to White populations. The researchers postulate that this might have been due to minorities getting tested at more severe stages of disease due to a lack of access to testing. In the other metrics, the hazard ratio was higher for South Asian people, mixed people, Black people, and “other” compared to the White population. Similar results were found in wave 2, except that South Asian hazard risk increased and Black hazard risk decreased. They hypothesized that multigenerational South Asian households increased infection susceptibility and that increased exposure, in general, contributed to the risk of death for minority populations (rather than increased disease severity susceptibility). The researchers show vast ethnic inequality and suggests increased access to testing, clinical care, and understanding how comorbidities affect COVID-19 may be crucial in reducing health disparities among populations in the UK.
Mathur R, Rentsch CT, Morton CE, et al. 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 (London, England) 2021; 0. DOI:10.1016/S0140-6736(21)00634-6.