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Ethnic minorities and COVID-19: examining whether excess risk is mediated through deprivation.
Razieh, Cameron; Zaccardi, Francesco; Islam, Nazrul; Gillies, Clare L; V Chudasama, Yogini; Rowlands, Alex; Kloecker, David E; Davies, Melanie J; Khunti, Kamlesh; Yates, Thomas.
  • Razieh C; Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK.
  • Zaccardi F; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC), Leicester General Hospital, Leicester LE5 4PW, UK.
  • Islam N; Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK.
  • Gillies CL; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK.
  • V Chudasama Y; Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
  • Rowlands A; Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK.
  • Kloecker DE; Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK.
  • Davies MJ; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK.
  • Khunti K; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK.
  • Yates T; Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK.
Eur J Public Health ; 31(3): 630-634, 2021 07 13.
Article in English | MEDLINE | ID: covidwho-1142653
Semantic information from SemMedBD (by NLM)
1. COVID-19 AFFECTS Black race
Subject
COVID-19
Predicate
AFFECTS
Object
Black race
2. COVID-19 AFFECTS Persons
Subject
COVID-19
Predicate
AFFECTS
Object
Persons
3. COVID-19 AFFECTS South Asian
Subject
COVID-19
Predicate
AFFECTS
Object
South Asian
4. COVID-19 PROCESS_OF Persons
Subject
COVID-19
Predicate
PROCESS_OF
Object
Persons
5. COVID-19 PROCESS_OF South Asian
Subject
COVID-19
Predicate
PROCESS_OF
Object
South Asian
6. COVID-19 CAUSES Cessation of life
Subject
COVID-19
Predicate
CAUSES
Object
Cessation of life
7. Cessation of life PROCESS_OF Caucasians
Subject
Cessation of life
Predicate
PROCESS_OF
Object
Caucasians
8. Severe disease PROCESS_OF Caucasians
Subject
Severe disease
Predicate
PROCESS_OF
Object
Caucasians
9. COVID-19 PROCESS_OF Caucasians
Subject
COVID-19
Predicate
PROCESS_OF
Object
Caucasians
10. Interventional procedure TREATS African American
Subject
Interventional procedure
Predicate
TREATS
Object
African American
11. Interventional procedure TREATS South Asian
Subject
Interventional procedure
Predicate
TREATS
Object
South Asian
12. COVID-19 AFFECTS Black race
Subject
COVID-19
Predicate
AFFECTS
Object
Black race
13. COVID-19 AFFECTS Persons
Subject
COVID-19
Predicate
AFFECTS
Object
Persons
14. COVID-19 AFFECTS South Asian
Subject
COVID-19
Predicate
AFFECTS
Object
South Asian
15. COVID-19 PROCESS_OF Persons
Subject
COVID-19
Predicate
PROCESS_OF
Object
Persons
16. COVID-19 PROCESS_OF South Asian
Subject
COVID-19
Predicate
PROCESS_OF
Object
South Asian
17. COVID-19 CAUSES Cessation of life
Subject
COVID-19
Predicate
CAUSES
Object
Cessation of life
18. Cessation of life PROCESS_OF Caucasians
Subject
Cessation of life
Predicate
PROCESS_OF
Object
Caucasians
19. Severe disease PROCESS_OF Caucasians
Subject
Severe disease
Predicate
PROCESS_OF
Object
Caucasians
20. COVID-19 PROCESS_OF Caucasians
Subject
COVID-19
Predicate
PROCESS_OF
Object
Caucasians
21. Interventional procedure TREATS African American
Subject
Interventional procedure
Predicate
TREATS
Object
African American
22. Interventional procedure TREATS South Asian
Subject
Interventional procedure
Predicate
TREATS
Object
South Asian
ABSTRACT

BACKGROUND:

People from South Asian and black minority ethnic groups are disproportionately affected by the COVID-19 pandemic. It is unknown whether deprivation mediates this excess ethnic risk.

METHODS:

We used UK Biobank with linked COVID-19 outcomes occurring between 16th March 2020 and 24th August 2020. A four-way decomposition mediation analysis was used to model the extent to which the excess risk of testing positive, severe disease and mortality for COVID-19 in South Asian and black individuals, relative to white individuals, would be eliminated if levels of high material deprivation were reduced within the population.

RESULTS:

We included 15 044 (53.0% women) South Asian and black and 392 786 (55.2% women) white individuals. There were 151 (1.0%) positive tests, 91 (0.6%) severe cases and 31 (0.2%) deaths due to COVID-19 in South Asian and black individuals compared with 1471 (0.4%), 895 (0.2%) and 313 (0.1%), respectively, in white individuals. Compared with white individuals, the relative risk of testing positive for COVID-19, developing severe disease and COVID-19 mortality in South Asian and black individuals were 2.73 (95% CI 2.26, 3.19), 2.96 (2.31, 3.61) and 4.04 (2.54, 5.55), respectively. A hypothetical intervention moving the 25% most deprived in the population out of deprivation was modelled to eliminate between 40 and 50% of the excess risk of all COVID-19 outcomes in South Asian and black populations, whereas moving the 50% most deprived out of deprivation would eliminate over 80% of the excess risk of COVID-19 outcomes.

CONCLUSIONS:

The excess risk of COVID-19 outcomes in South Asian and black communities could be substantially reduced with population level policies targeting material deprivation.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: COVID-19 Subject: COVID-19 Type of study: Etiology study / Risk factors Language: English Journal: Eur J Public Health Clinical aspect: Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: COVID-19 Subject: COVID-19 Type of study: Etiology study / Risk factors Language: English Journal: Eur J Public Health Clinical aspect: Etiology Year: 2021
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