Center for Genomic Medicine and Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
Int J Equity Health. 2020 Jul 6;19(1):114. doi: 10.1186/s12939-020-01227-y.
Preliminary reports suggest that the Coronavirus Disease 2019 (COVID- 19) pandemic has led to disproportionate morbidity and mortality among historically disadvantaged populations. 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 3.7; 95%CI 2.5-5.3) and Asian participants (odds ratio 2.2; 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 socioeconomic factors and cardiorespiratory comorbidities led to only modest attenuation of the increased risk in Black participants, adjusted odds ratio 2.4 (95%CI 1.5-3.7). 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.
初步报告表明,2019 年冠状病毒病(COVID-19)大流行导致历史上处于不利地位的人群发病率和死亡率不成比例。我们调查了英国生物银行 418794 名参与者中 COVID-19 住院的种族和社会经济关联,其中 549 人(0.13%)住院。与白人参与者相比,黑人参与者(优势比 3.7;95%CI 2.5-5.3)和亚洲参与者(优势比 2.2;95%CI 1.5-3.2)的风险明显增加。我们还观察到,根据汤森贫困指数(一种社会经济剥夺的综合衡量标准)和家庭收入,COVID-19 住院率存在显著梯度。调整社会经济因素和心肺共病后,黑人参与者的风险增加幅度仅略有降低,调整后的优势比为 2.4(95%CI 1.5-3.7)。这些观察结果证实并扩展了先前关于在全国生物银行的大量参与者中,非白人个体发病率更高的初步和大众媒体报道。这种风险增加与先前存在的合并症、检测或住院模式的差异,或健康社会决定因素的其他差异有关,值得进一步研究。