Abstract
It is unclear if changes in public behaviours, developments in COVID-19 treatments, improved patient care, and directed policy initiatives have altered outcomes for minority ethnic groups in the second pandemic wave. This was a prospective analysis of patients aged ≥ 16 years having an emergency admission with SARS-CoV-2 infection between 01/09/2020 and 17/02/2021 to acute NHS hospitals in east London. Multivariable survival analysis was used to assess associations between ethnicity and mortality accounting for predefined risk factors. Age-standardised rates of hospital admission relative to the local population were compared between ethnic groups. Of 5533 patients, the ethnic distribution was White (n = 1805, 32.6%), Asian/Asian British (n = 1983, 35.8%), Black/Black British (n = 634, 11.4%), Mixed/Other (n = 433, 7.8%), and unknown (n = 678, 12.2%). Excluding 678 patients with missing data, 4855 were included in multivariable analysis. Relative to the White population, Asian and Black populations experienced 4.1 times (3.77–4.39) and 2.1 times (1.88–2.33) higher rates of age-standardised hospital admission. After adjustment for various patient risk factors including age, sex, and socioeconomic deprivation, Asian patients were at significantly higher risk of death within 30 days (HR 1.47 [1.24–1.73]). No association with increased risk of death in hospitalised patients was observed for Black or Mixed/Other ethnicity. Asian and Black ethnic groups continue to experience poor outcomes following COVID-19. Despite higher-than-expected rates of hospital admission, Black and Asian patients also experienced similar or greater risk of death in hospital since the start of the pandemic, implying a higher overall risk of COVID-19 associated death in these communities.
Highlights
Multiple studies have described increased mortality in Black and Asian people with COVID-19 in the U K1–5
Diabetes and chronic kidney disease (CKD) were more prevalent at an earlier age in Asian and Black patients, frailty and dementia were more prevalent in older White patients (Table 1, Table S2)
The principal finding of this study was that amongst 5533 patients hospitalised with COVID-19 in the ethnically diverse area of east London during the second wave, there remained important ethnic disparities in patient outcomes
Summary
Multiple studies have described increased mortality in Black and Asian people with COVID-19 in the U K1–5. In many of these reports, Black people were at equal or greater risk of death than Asian people These studies have included large analyses of hospitalised patients and analyses of COVID-19 associated deaths within large sets of primary care r ecords[5]. Across four acute NHS hospitals in this region, we continued to treat high acuity patients and centralised surge critical care capacity on one site in a purpose-built ICU (The Queen Elizabeth Unit). This large, regional dataset afforded extensive analyses of COVID-19 patients to further characterise the risk factors within different ethnic groups of hospitalised COVID-19 patients. We aimed to determine if ethnic disparities during the first wave of COVID-19 have been mitigated during the second wave and the long-term survival of the first wave patients after one year
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