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英国生物银行英国参与者中种族、社会经济剥夺与COVID-19住院情况

Race, Socioeconomic Deprivation, and Hospitalization for COVID-19 in English participants of a National Biobank.

作者信息

Patel Aniruddh Pradip, Paranjpe Manish D, Kathiresan Nina P, Rivas Manuel A, Khera Amit V

出版信息

medRxiv. 2020 May 2:2020.04.27.20082107. doi: 10.1101/2020.04.27.20082107.

Abstract

Preliminary reports suggest that the Coronavirus Disease 2019 (COVID-19) pandemic has led to disproportionate morbidity and mortality among historically disadvantaged populations. The extent to which these disparities are related to socioeconomic versus biologic factors is largely unknown. We investigate the racial and socioeconomic associations of COVID-19 hospitalization among 418,794 participants of the UK Biobank, of whom 549 (0.13%) had been hospitalized. Both black participants (odds ratio 3.4; 95%CI 2.4-4.9) and Asian participants (odds ratio 2.1; 95%CI 1.5-3.2) were at substantially increased risk as compared to white participants. We further observed a striking gradient in COVID-19 hospitalization rates according to the Townsend Deprivation Index - a composite measure of socioeconomic deprivation - and household income. Adjusting for such factors led to only modest attenuation of the increased risk in black participants, adjusted odds ratio 3.1 (95%CI 2.0-4.8). These observations confirm and extend earlier preliminary and lay press reports of higher morbidity in non-white individuals in the context of a large population of participants in a national biobank. The extent to which this increased risk relates to variation in pre-existing comorbidities, differences in testing or hospitalization patterns, or additional disparities in social determinants of health warrants further study.

摘要

初步报告表明,2019冠状病毒病(COVID-19)大流行在历史上处于弱势的人群中导致了不成比例的发病率和死亡率。这些差异在多大程度上与社会经济因素而非生物学因素有关,目前尚不清楚。我们调查了英国生物银行418,794名参与者中COVID-19住院治疗的种族和社会经济关联,其中549人(0.13%)曾住院治疗。与白人参与者相比,黑人参与者(比值比3.4;95%置信区间2.4-4.9)和亚洲参与者(比值比2.1;95%置信区间1.5-3.2)的风险均大幅增加。我们还根据汤森贫困指数(一种社会经济剥夺的综合衡量指标)和家庭收入观察到COVID-19住院率存在显著梯度。对这些因素进行调整后,黑人参与者增加的风险仅略有降低,调整后的比值比为3.1(95%置信区间2.0-4.8)。这些观察结果证实并扩展了早期关于国家生物银行大量参与者中非白人个体发病率较高的初步和大众媒体报道。这种增加的风险在多大程度上与既往合并症的差异、检测或住院模式的不同,或健康社会决定因素中的其他差异有关,值得进一步研究。

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