Greater risk of severe COVID-19 in Black, Asian and Minority Ethnic populations is not explained by cardiometabolic, socioeconomic or behavioural factors, or by 25(OH)-vitamin D status: study of 1326 cases from the UK Biobank
Greater risk of severe COVID-19 in Black, Asian and Minority Ethnic populations is not explained by cardiometabolic, socioeconomic or behavioural factors, or by 25(OH)-vitamin D status: study of 1326 cases from the UK Biobank
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DOI：
10.1093/pubmed/fdaa095
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发表时间：
2020-09-01
影响因子：
4.4
通讯作者：
Petersen, Steffen E.
中科院分区：
文献类型：
--
作者：
Raisi-Estabragh, Zahra;McCracken, Celeste;Petersen, Steffen E.
背景 我们研究了男性以及黑人、亚洲人和少数族裔 (BAME) 个体中 2019 年冠状病毒病 (COVID-19) 的严重程度是否可以通过心脏代谢、社会经济或行为因素来解释。 方法 我们研究了 4510 名接受过 COVID-19 检测的英国生物银行参与者（阳性，n = 1326）。使用包括年龄、性别和种族在内的多变量逻辑回归模型来测试是否添加（1）心脏代谢因素[糖尿病、高血压、高胆固醇、既往心肌梗塞、吸烟和体重指数（BMI）]； (2) 25(OH)-维生素D； (3)饮食不良； (4)汤森剥夺评分； (5) 住房（家庭类型、过度拥挤）或 (6) 行为因素（社交性、冒险精神）减弱了性别/种族与 COVID-19 状态的关联。结果 在 COVID-19 阳性群体中，男性和 BAME 族裔的比例过高。平均而言，少数族裔、少数族裔人士的心脏代谢状况较差，25(OH)-维生素 D 含量较低，物质匮乏程度较高，并且更有可能居住在较大的家庭和公寓/公寓中。男性、BAME 种族、较高的 BMI、较高的 Townsend 剥夺评分和家庭过度拥挤与 COVID-19 的显着增加独立相关。男性和女性的关联模式是一致的；心脏代谢、社会人口和行为因素并没有减弱性别/种族关联。 结论 在这项研究中，心脏代谢因素、25(OH)-维生素 D 水平或社会经济因素的变化不能充分解释 COVID-19 的性别和种族差异模式。 COVID-19 种族差异背后的因素可能不容易被捕获，因此应优先考虑替代生物和遗传易感性的调查以及对复杂的经济、社会和行为差异的更全面的评估。
Background We examined whether the greater severity of coronavirus disease 2019 (COVID-19) amongst men and Black, Asian and Minority Ethnic (BAME) individuals is explained by cardiometabolic, socio-economic or behavioural factors.Methods We studied 4510 UK Biobank participants tested for COVID-19 (positive, n = 1326). Multivariate logistic regression models including age, sex and ethnicity were used to test whether addition of (1) cardiometabolic factors [diabetes, hypertension, high cholesterol, prior myocardial infarction, smoking and body mass index (BMI)]; (2) 25(OH)-vitamin D; (3) poor diet; (4) Townsend deprivation score; (5) housing (home type, overcrowding) or (6) behavioural factors (sociability, risk taking) attenuated sex/ethnicity associations with COVID-19 status.Results There was over-representation of men and BAME ethnicities in the COVID-19 positive group. BAME individuals had, on average, poorer cardiometabolic profile, lower 25(OH)-vitamin D, greater material deprivation, and were more likely to live in larger households and in flats/apartments. Male sex, BAME ethnicity, higher BMI, higher Townsend deprivation score and household overcrowding were independently associated with significantly greater odds of COVID-19. The pattern of association was consistent for men and women; cardiometabolic, socio-demographic and behavioural factors did not attenuate sex/ethnicity associations.Conclusions In this study, sex and ethnicity differential pattern of COVID-19 was not adequately explained by variations in cardiometabolic factors, 25(OH)-vitamin D levels or socio-economic factors. Factors which underlie ethnic differences in COVID-19 may not be easily captured, and so investigation of alternative biological and genetic susceptibilities as well as more comprehensive assessment of the complex economic, social and behavioural differences should be prioritised.