Ethnic disparities in hospitalisation for COVID-19 in England: The role of socioeconomic factors, mental health, and inflammatory and pro-inflammatory factors in a community-based cohort study
Ethnic disparities in hospitalisation for COVID-19 in England: The role of socioeconomic factors, mental health, and inflammatory and pro-inflammatory factors in a community-based cohort study
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DOI：
10.1016/j.bbi.2020.05.074
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发表时间：
2020-08-01
影响因子：
15.1
通讯作者：
Batty, G. David
中科院分区：
文献类型：
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作者：
Lassale, Camille;Gaye, Bamba;Batty, G. David
背景：已报道了COVID-19住院和死亡率根据种族的差异，但其起源尚不确定。方法：我们使用了来自英国生物银行研究的340，966名男性和女性（平均年龄56.2岁）的数据，这是一项与COVID-19住院相关的前瞻性队列研究。结果：共有640例COVID-19病例（571/324，306白色，31/4，485黑人，21/5，732亚洲人，17/5，803其他）。与白色研究成员相比，在调整年龄和性别后，黑人个体感染COVID-19的风险增加了4倍以上（比值比; 95%置信区间：4.32; 3.00-6.23），亚洲组的风险加倍（2.12; 1.37，3.28）和“其他”非白人组（1.84; 1.13，2.99）。在控制了潜在的解释因素，包括邻里剥夺，家庭拥挤，吸烟，体型，炎症，糖化血红蛋白和精神疾病后，这些效应估计值在黑人中减弱了33%，在亚洲人中减弱了52%，在其他人中减弱了43%，但在黑人中仍然升高（2.66; 1.82，3.91），亚洲人（1.43; 0.91，2.26）和其他非白人群体（1.41; 0.87，2.31）。结论：COVID-19住院风险存在明显的种族差异，这些似乎不能用测量因素完全解释。如果复制，我们的研究结果对卫生政策有影响，包括预防咨询和疫苗接种覆盖率的目标。
Background: Differentials in COVID-19 hospitalisations and mortality according to ethnicity have been reported but their origin is uncertain. We examined the role of socioeconomic, mental health, and pro-inflammatory factors in a community-based sample.Methods: We used data on 340,966 men and women (mean age 56.2 years) from the UK Biobank study, a prospective cohort study with linkage to hospitalisation for COVID-19. Logistic regression models were used to estimate associations between ethnicity and hospitalisation for COVID-19.Results: There were 640 COVID-19 cases (571/324,306 White, 31/4,485 Black, 21/5,732 Asian, 17/5,803 Other). Compared to the White study members and after adjusting for age and sex, Black individuals had over a 4-fold increased risk of COVID-19 infection (odds ratio; 95% confidence interval: 4.32; 3.00-6.23), and there was a doubling of risk in the Asian group (2.12; 1.37, 3.28) and the 'other' non-white group (1.84; 1.13, 2.99). After controlling for potential explanatory factors which included neighbourhood deprivation, household crowding, smoking, body size, inflammation, glycated haemoglobin, and mental illness, these effect estimates were attenuated by 33% for Blacks, 52% for Asians and 43% for Other, but remained raised for Blacks (2.66; 1.82, 3.91), Asian (1.43; 0.91, 2.26) and other non-white groups (1.41; 0.87, 2.31).Conclusions: There were clear ethnic differences in risk of COVID-19 hospitalisation and these do not appear to be fully explained by measured factors. If replicated, our results have implications for health policy, including the targeting of prevention advice and vaccination coverage.