Rohini Mathur|Christopher T Rentsch|Caroline E Morton|William Hulme|Anna Schultze|Brian MacKenna|Rosalind M Eggo|Krishnan Bhaskaran|Angel YS Wong|Elizabeth Williamson|Harriet Forbes|Kevin Wing|Helen I McDonald|Chris Bates|Seb Bacon|Alex J Walker|David Evans|Peter Inglesby|Amir Mehrkar|Helen J Curtis|Nicholas DeVito|Richard Croker|Henry Drysdale|Jonathan Cockburn|J. H. Parry|Frank Hester|Sam Harper|Ian Douglas|Laurie Tomlinson|Stephen Evans|Richard Grieve|David A Harrison|Kathy Rowan|Kamlesh Khunti|Nishi Chaturvedi|Liam Smeeth|Ben Goldacre
Ethnic differences in SARS-CoV-2 infection and COVID-19-related hospitalisation, intensive care unit admission, and death in 17 million adults in England: an observational cohort study using the OpenSAFELY platform
London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|University of Oxford|University of Oxford|London School of Hygiene & Tropical Medicine|University of Oxford|London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|University of Oxford|London School of Hygiene & Tropical Medicine|National Institute for Health Research|WPP (United Kingdom)|University of Oxford|University of Oxford|University of Oxford|University of Oxford|University of Oxford|University of Oxford|University of Oxford|University of Oxford|University of Oxford|WPP (United Kingdom)|WPP (United Kingdom)|WPP (United Kingdom)|WPP (United Kingdom)|London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|Intensive Care National Audit & Research Centre|Intensive Care National Audit & Research Centre|University of Leicester|MRC Unit for Lifelong Health and Ageing|University College London|Medical Research Council|London School of Hygiene & Tropical Medicine|University of Oxford
covid19 disproportionately affected minority ethnic populations uk aim quantify ethnic differences sarscov2 infection covid19 outcomes first second waves covid19 pandemic englandwe conducted observational cohort study adults aged 18 years registered primary care practices england electronic health records available opensafely platform least 1 year continuous registration start study period feb 1 aug 3 2020 wave 1 sept 1 dec 31 2020 wave 2 individuallevel primary care data linked data sources outcomes interest sarscov2 testing positive test results covid19related hospital admissions intensive care unit icu admissions death exposure selfreported ethnicity captured primary care record grouped five highlevel census categories white south asian black mixed 16 subcategories across five categories well unknown ethnicity category used multivariable cox regression examine ethnic differences outcomes interest models adjusted age sex deprivation clinical factors comorbidities household size stratification geographical regionof 17 288 532 adults included study excluding care home residents 10 877 978 629 white 1 025 319 59 south asian 340 912 20 black 170 484 10 mixed ethnicity 320 788 19 ethnicity 4 553 051 263 unknown ethnicity wave 1 likelihood tested sarscov2 infection slightly higher south asian group adjusted hazard ratio 108 95 ci 107109 black group 108 106109 mixed ethnicity group 104 102105 decreased ethnicity group 077 076078 relative white group risk testing positive sarscov2 infection higher south asian group 199 194204 black group 169 162177 mixed ethnicity group 149 139159 ethnicity group 120 114128 compared white group four remaining highlevel ethnic groups increased risk covid19related hospitalisation south asian group 148 141155 black group 178 167190 mixed ethnicity group 163 145183 ethnicity group 154 141169 covid19related icu admission 218 192248 312 265367 296 226387 318 258393 death 126 115137 151 131171 141 111181 122 100148 wave 2 risks hospitalisation icu admission death relative white group increased south asian group attenuated black group compared risks wave 1 disaggregation 16 ethnicity groups showed important heterogeneity within five broader categoriessome minority ethnic populations england excess risks testing positive sarscov2 adverse covid19 outcomes compared white population even accounting differences sociodemographic clinical household characteristics causes likely multifactorial delineating exact mechanisms crucial tackling ethnic inequalities require action across many fronts including reducing structural inequalities addressing barriers equitable care improving uptake testing vaccinationmedical research council