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Black and Asian people in U.K. at higher risk of death from COVID-19: study
TORONTO -- A new study out of the United Kingdom has discovered that black and Asian people are at a higher risk of in-hospital death due to COVID-19 compared to white people.
According to the study released Thursday, black people are about twice as likely to die from COVID-19 compared to those who listed their ethnicity as white, at a ratio of about 1.71. Similar results were obtained for those of Asian or Asian-British ethnicity, who are 1.62 times more likely to die as a result of COVID-19.
“There have been reports already in the U.K. that people from black and minority ethnic backgrounds…that they seem to be at an increased risk of…being on intensive care and dying from COVID,” explained Liam Smeeth, a clinical epidemiology professor at the London School of Hygiene and Tropical Medicine (LSHTM). Smeeth is also the co-lead of the study.
“We knew there was an increased risk in these groups – it’s a matter a trying to disentangle why that risk is happening and therefore, what we can do about it.”
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The study was conducted by the University of Oxford in collaboration with the London School of Hygiene and Tropical Medicine (LSHTM). It is based on the electronic health records of more than 17.4 million adults in the U.K. between February 1 and April 25, making it the largest study on COVID-19 conducted by any country to date.
Previous studies have hypothesized that this increased risk of death among black and Asian ethnic groups may be due to higher prevalence of underlying health conditions such as cardiovascular disease or diabetes. Smeeth says this new study offers some clarification.
“When it was first noticed that people from black and minority ethnic groups had a higher risk of bad outcomes from COVID, the obvious thing to think was, ‘is it because they’ve got a high risk of diabetes, a high risk of obesity and a high risk of high blood pressure?’” he said. “While those underlying illnesses contribute a little bit of the increased risk, they actually don’t contribute that much.”
As part of the study, researchers examined more than 17 million long-term medical records pertaining to all those involved, including the 5,683 who died as a result of COVID-19. Based on this detailed clinical data, it was concluded that there is a good chance most of this increased risk of dying stems from greater exposure to the virus, as opposed to pre-existing medical conditions. Smeeth said this is likely due to an over-representation among these groups in front-line jobs, as well as higher household density.
“We haven’t got data on those social factors – our data are clinical in nature – but it does look much more likely that this is where the explanations will lie,” said Smeeth.
More than 1,870,000 people – 11 per cent of the sample – did not identify as white. Additionally, about 26 per cent of patients did not identify an ethnicity at all.
Other known risk factors of COVID-19 death include gender and age, with men and those older in age being more likely to die from the virus. Obesity is also emerging as another major risk factor in contracting COVID-19 as well as requiring serious hospital care as a result.
The study conducted by the University of Oxford also discovered that those with uncontrolled diabetes are at an increased risk of dying from COVID-19, as are those with severe asthma.
“The report really backs up the policies taken across most parts of the world…of paying particular attention to people with underlying health conditions and really making extra effort to protect them form the risk of infection,” said Smeeth.
The Public Health Agency of Canada has pointed to those with other pre-existing medical conditions such as heart disease, high blood pressure, lung disease and cancer, as being at a high risk of developing severe complications from COVID-19. Those with a weak immune system from a medical condition or treatments like chemotherapy are also at a greater risk.
The World Health Organization also notes that the elderly and people with pre-existing medical conditions appear to develop more serious illness.
In addition to age, gender, and underlying medical conditions, the Centers for Disease Control and Prevention also point to poverty and crowding as well as pregnancy as potential risk factors for severe illness or complications due to COVID-19.
Despite all the research already conducted on this topic, Smeeth insists that more research must be done, especially regarding the impact of the virus on black and ethnic minority groups as well as other risk factors that would make someone more likely to die from COVID-19.
“When people are unwell…who is it I should be particularly worried about? Who is it who warrants hospital admission or much more intensive observation?” said Smeeth. “The reason why we’re interested to know what the risk factors are for death from COVID is it lets you guide policy on who needs protection.”
The study was conducted on behalf of England’s National Health Service (NHS) and in partnership with NHSX, a U.K. government organization responsible for setting national policy and developing best practice for NHS technology.