Thursday, 12 November 2020
People of Black ethnicity are twice as likely to be infected with COVID-19 compared to those of White ethnicity, according to researchers at the Universities of Leicester and Nottingham.
The findings, published today in EClinical Medicine, show that people from Asian backgrounds are also 1.5 times more likely to become infected with the virus compared to White individuals.
In the first meta-analysis of the effect of ethnicity on clinical outcomes in patients with COVID-19, which screened over 1500 articles, the research team pooled data from more than 18 million people who had taken part in 50 studies in the United Kingdom and United States of America. All the studies included in the analysis were published between 1 December 2019 and 31 August 2020 in peer-reviewed journals or as pre-prints waiting for peer-review.
All the patients included in the study who had COVID-19 were defined as such by a positive nasal swab test or clinical signs and symptoms of the virus, along with radiology and laboratory tests.
Researchers also found those of Asian ethnicities to be at higher risk of admission to an intensive therapy unit (ITU) and death. However, all studies investigating ITU admission that were included in the meta-analysis had not yet been peer-reviewed, and the risk of death was only of borderline statistical significance. This is in contrast to the strong evidence of increased risk of infection in Black and Asian ethnic groups.
Dr Laura B Nellums, Assistant Professor in Global Health in the Division of Epidemiology and Public Health at the University of Nottingham and joint senior author of the paper, said: "There is increasing evidence of ethnic disparities in COVID-19, with poorer outcomes among ethnic minority groups in the wider community as well as those working in healthcare settings. However, there has not been a robust synthesis of emerging data to understand which groups may be disproportionately affected, or the inequities driving poorer outcomes in ethnic minority communities."
Dr Laura B Nellums
“This systematic review and meta-synthesis represents the first comprehensive examination of all available evidence on ethnicity and COVID-19, encompassing more than 18 million individuals. The findings highlight the higher risk of infection among individuals from Black and Asian ethnicities, which is likely driven by social and structural inequities. The research also underscores the significant gaps that still exist in the meaningful collection and reporting of data on ethnicity. There is an urgent need in research, policy, and practice, not only to reduce the risk of COVID-19 infection and consequently poor outcomes in individuals from ethnic minority backgrounds, but also to address the wider social, economic, and systemic inequities driving disparities in access to care and health outcomes in these communities.”
Dr Manish Pareek, Associate Clinical Professor in Infectious Diseases at the University of Leicester, Consultant in Infectious Diseases at the University Hospitals of Leicester NHS Trust and a senior author on the paper, said: “Our findings suggest that the disproportionate impact of COVID-19 on Black and Asian communities is mainly attributable to increased risk of infection in these communities.
“Many explanations exist as to why there may be an elevated level of COVID-19 infection in ethnic minority groups, including: the greater likelihood of living in larger household sizes comprised of multiple generations; having lower socioeconomic status, which may increase the likelihood of living in overcrowded households; and being employed in frontline roles where working from home is not an option.
The research is supported by the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre.
Dr Nellums receives funding from the Academy of Medical Sciences (SBF005\1047), the Medical Research Council/Economic and Social Research Council/Arts and Humanities Research Council (MR/T046732/1), and UKRI/MRC (MR/V027549/1).
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More information is available from Dr Laura B Nellums, Assistant Professor in Global Health in the Division of Epidemiology and Public Health at Laura.Nellums@nottingham.ac.uk
Notes to editors:
About the University of Nottingham
Ranked 32 in Europe and 16th in the UK by the QS World University Rankings: Europe 2024, the University of Nottingham is a founding member of the Russell Group of research-intensive universities. Studying at the University of Nottingham is a life-changing experience, and we pride ourselves on unlocking the potential of our students. We have a pioneering spirit, expressed in the vision of our founder Sir Jesse Boot, which has seen us lead the way in establishing campuses in China and Malaysia - part of a globally connected network of education, research and industrial engagement.
Nottingham was crowned Sports University of the Year by The Times and Sunday Times Good University Guide 2024 – the third time it has been given the honour since 2018 – and by the Daily Mail University Guide 2024.
The university is among the best universities in the UK for the strength of our research, positioned seventh for research power in the UK according to REF 2021. The birthplace of discoveries such as MRI and ibuprofen, our innovations transform lives and tackle global problems such as sustainable food supplies, ending modern slavery, developing greener transport, and reducing reliance on fossil fuels.
The university is a major employer and industry partner - locally and globally - and our graduates are the second most targeted by the UK's top employers, according to The Graduate Market in 2022 report by High Fliers Research.
We lead the Universities for Nottingham initiative, in partnership with Nottingham Trent University, a pioneering collaboration between the city’s two world-class institutions to improve levels of prosperity, opportunity, sustainability, health and wellbeing for residents in the city and region we are proud to call home.
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