Ethnic and socioeconomic differences in SARS-CoV-2 infection: prospective cohort study using UK Biobank

Niedzwiedz, C. L. et al. (2020) Ethnic and socioeconomic differences in SARS-CoV-2 infection: prospective cohort study using UK Biobank. BMC Medicine, 18, 160. (doi: 10.1186/s12916-020-01640-8) (PMID:32466757) (PMCID:PMC7255908)

[img]
Preview
Text
214744.pdf - Published Version
Available under License Creative Commons Attribution.

1MB

Abstract

Background Understanding of the role of ethnicity and socioeconomic position in the risk of developing SARS-CoV-2 infection is limited. We investigated this in the UK Biobank study. Methods The UK Biobank study recruited 40–70-year-olds in 2006–2010 from the general population, collecting information about self-defined ethnicity and socioeconomic variables (including area-level socioeconomic deprivation and educational attainment). SARS-CoV-2 test results from Public Health England were linked to baseline UK Biobank data. Poisson regression with robust standard errors was used to assess risk ratios (RRs) between the exposures and dichotomous variables for being tested, having a positive test and testing positive in hospital. We also investigated whether ethnicity and socioeconomic position were associated with having a positive test amongst those tested. We adjusted for covariates including age, sex, social variables (including healthcare work and household size), behavioural risk factors and baseline health. Results Amongst 392,116 participants in England, 2658 had been tested for SARS-CoV-2 and 948 tested positive (726 in hospital) between 16 March and 3 May 2020. Black and south Asian groups were more likely to test positive (RR 3.35 (95% CI 2.48–4.53) and RR 2.42 (95% CI 1.75–3.36) respectively), with Pakistani ethnicity at highest risk within the south Asian group (RR 3.24 (95% CI 1.73–6.07)). These ethnic groups were more likely to be hospital cases compared to the white British. Adjustment for baseline health and behavioural risk factors led to little change, with only modest attenuation when accounting for socioeconomic variables. Socioeconomic deprivation and having no qualifications were consistently associated with a higher risk of confirmed infection (RR 2.19 for most deprived quartile vs least (95% CI 1.80–2.66) and RR 2.00 for no qualifications vs degree (95% CI 1.66–2.42)). Conclusions Some minority ethnic groups have a higher risk of confirmed SARS-CoV-2 infection in the UK Biobank study, which was not accounted for by differences in socioeconomic conditions, baseline self-reported health or behavioural risk factors. An urgent response to addressing these elevated risks is required.

Item Type:Articles
Additional Information:CLN acknowledges funding from a Medical Research Council Fellowship (MR/R024774/1). ED and SVK acknowledge funding from the Medical Research Council (MC_UU_12017/13) and Scottish Government Chief Scientist Office (SPHSU13). SVK also acknowledges funding from a NRS Senior Clinical Fellowship (SCAF/15/02).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Katikireddi, Dr Vittal and Celis, Dr Carlos and Jani, Dr Bhautesh and Ho, Dr Frederick and Demou, Dr Evangelia and Welsh, Dr Paul and Pell, Professor Jill and Sattar, Professor Naveed and Niedzwiedz, Dr Claire and Nicholl, Dr Barbara and Mair, Professor Frances and O'Donnell, Professor Kate
Authors: Niedzwiedz, C. L., O'Donnell, C. A., Jani, B. D., Demou, E., Ho, F. K., Celis-Morales, C., Nicholl, B. I., Mair, F. S., Welsh, P., Sattar, N., Pell, J. P., and Katikireddi, S. V.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:BMC Medicine
Publisher:BioMed Central
ISSN:1741-7015
ISSN (Online):1741-7015
Copyright Holders:Copyright © The Author(s). 2020
First Published:First published in BMC Medicine 18:160
Publisher Policy:Reproduced under a Creative Commons licence
Related URLs:

University Staff: Request a correction | Enlighten Editors: Update this record

Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727651SPHSU Core Renewal: Measuring and Analysing Socioeconomic Inequalities in Health Research ProgrammeAlastair LeylandMedical Research Council (MRC)MC_UU_12017/13IHW - MRC/CSO SPHU
SPHSU13
172690Understanding the impacts of welfare policy on health: A novel data linkage studySrinivasa KatikireddiChief Scientist Office (CSO)SCAF/15/02HW - Public Health
302182A machine learning approach to understanding comorbidity between mental and physical health conditionsClaire NiedzwiedzMedical Research Council (MRC)MR/R024774/1HW - Public Health