Highlights • Ethnic differentials in COVID-19 burden are reported but their origin is uncertain. • In a UK cohort, Black and Asian individuals had a higher COVID-19 hospitalisation risk. • Black individuals had more than a doubling of risk compared to White individuals. • This held after adjusting for socioeconomic, physical and mental health confounders. • The effect for the Asian group was diminished. • Implications for health policy include targeting of prevention and vaccination. 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.
【저자키워드】 COVID-19, inflammatory factors, Ethnicity, 【초록키워드】 Inflammation, vaccination, Mortality, mental health, UK biobank, risk, smoking, prospective cohort study, Haemoglobin, Cohort, Coverage, Health, COVID-19 infection, Regression model, Factors, age, estimate, group, hospitalisation, Other, association, Deprivation, Asian, black, Factor, increased risk, COVID-19 case, individual, confounders, white, doubling, mental illness, COVID-19 hospitalisation, implication, risk of COVID-19, physical, Result, examined, include, reported, remained, raised, were used, explained, replicated, individuals, age and sex, men and women, had more, pro-inflammatory factor, used data, 【제목키워드】 mental health, hospitalisation, Inflammatory, Socioeconomic Factors, community-based cohort study, pro-inflammatory factor,