ArticleEClinicalMedicine2020
A case-control and cohort study to determine the relationship between ethnic background and severe COVID-19.
Article in EClinicalMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- Ethnic inequalities in multiple long-term health conditions in the United Kingdom: a systematic review and narrative synthesis.BMC public health · 2023Pooled it
- A systematic review of racial/ethnic and socioeconomic disparities in COVID-19.International journal for equity in health · 2021Pooled it
- A syndemic approach to the study of Covid-19-related death: a cohort study using UK Biobank data.Journal of public health (Oxford, England) · 2025Article
- SARS-CoV-2 infection boosts inflammation in atherosclerotic plaques.Nature cardiovascular research · 2023Article
- Demographics and Outcomes of Extracorporeal Membrane Oxygenation in COVID-19 Patients: National Database Analysis.Journal of clinical medicine · 2023Article
- Association of COVID-19 with Comorbidities: An Update.ACS pharmacology & translational science · 2023Review
- COVID-19 and diabetes in 2020: a systematic review.Journal of pharmaceutical policy and practice · 2023Review
- Risk of Covid-19 Severe Outcomes and Mortality in Migrants and Ethnic Minorities Compared to the General Population in the European WHO Region: a Systematic Review.Journal of international migration and integration · 2023Article
- Review
- Waning Effectiveness of the BNT162b2 Vaccine Against Infection in Adolescents in Israel.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Immigrant background and socioeconomic status are associated with severe COVID-19 requiring intensive care.Scientific reports · 2022Article
- Cardiometabolic outcomes up to 12 months after COVID-19 infection. A matched cohort study in the UK.PLoS medicine · 2022Article
- The pathological maelstrom of COVID-19 and cardiovascular disease.Nature cardiovascular research · 2022Review
- Odds of Testing Positive for SARS-CoV-2 Following Receipt of 3 vs 2 Doses of the BNT162b2 mRNA Vaccine.JAMA internal medicine · 2022Article
- Waning Effectiveness of the BNT162b2 Vaccine Against Infection in Adolescents.medRxiv : the preprint server for health sciences · 2022Article
- Inpatient COVID-19 mortality has reduced over time: Results from an observational cohort.PloS one · 2022Observational
- Observational
- Reporting of health equity considerations in equity-relevant observational studies: Protocol for a systematic assessment.F1000Research · 2022Article
- Outcomes and Risk Factors for Cardiovascular Events in Hospitalized COVID-19 Patients.Journal of cardiothoracic and vascular anesthesia · 2021Article
- Predicting coronavirus disease (COVID-19) outcomes in the United States early in the epidemic.Preventive medicine reports · 2021Article
Corrections and comments
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Authors and funding
18 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundPeople of minority ethnic backgrounds may be disproportionately affected by severe COVID-19. Whether this relates to increased infection risk, more severe disease progression, or worse in-hospital survival is unknown. The contribution of comorbidities or socioeconomic deprivation to ethnic patterning of outcomes is also unclear.
methodsWe conducted a case-control and a cohort study in an inner city primary and secondary care setting to examine whether ethnic background affects the risk of hospital admission with severe COVID-19 and/or in-hospital mortality. Inner city adult residents admitted to hospital with confirmed COVID-19 (
findingsThe 872 cases comprised 48.1% Black, 33.7% White, 12.6% Mixed/Other and 5.6% Asian patients. In conditional logistic regression analyses, Black and Mixed/Other ethnicity were associated with higher admission risk than white (OR 3.12 [95% CI 2.63-3.71] and 2.97 [2.30-3.85] respectively). Adjustment for comorbidities and deprivation modestly attenuated the association (OR 2.24 [1.83-2.74] for Black, 2.70 [2.03-3.59] for Mixed/Other). Asian ethnicity was not associated with higher admission risk (adjusted OR 1.01 [0.70-1.46]). In the cohort study of 1827 patients, 455 (28.9%) died over a median (IQR) of 8 (4-16) days. Age and male sex, but not Black (adjusted HR 1.06 [0.82-1.37]) or Mixed/Other ethnicity (adjusted HR 0.72 [0.47-1.10]), were associated with in-hospital mortality. Asian ethnicity was associated with higher in-hospital mortality but with a large confidence interval (adjusted HR 1.71 [1.15-2.56]).
interpretationBlack and Mixed ethnicity are independently associated with greater admission risk with COVID-19 and may be risk factors for development of severe disease, but do not affect in-hospital mortality risk. Comorbidities and socioeconomic factors only partly account for this and additional ethnicity-related factors may play a large role. The impact of COVID-19 may be different in Asians.
fundingBritish Heart Foundation; the National Institute for Health Research; Health Data Research UK.
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