Teece Lucy, Gray Laura J, Melbourne Carl, Orton Chris, Ford David V, Martin Christopher A, McAllister David, Khunti Kamlesh, Tobin Martin, John Catherine, Abrams Keith R, Pareek Manish
Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK.
Genetic Epidemiology Research Group, Department of Health Sciences, University of Leicester, Leicester, UK.
BMJ Open. 2021 Jun 28;11(6):e046392. doi: 10.1136/bmjopen-2020-046392.
COVID-19 has spread rapidly worldwide, causing significant morbidity and mortality. People from ethnic minorities, particularly those working in healthcare settings, have been disproportionately affected. Current evidence of the association between ethnicity and COVID-19 outcomes in people working in healthcare settings is insufficient to inform plans to address health inequalities.
This study combines anonymised human resource databases with professional registration and National Health Service data sets to assess associations between ethnicity and COVID-19 diagnosis, hospitalisation and death in healthcare workers in the UK. Adverse COVID-19 outcomes will be assessed between 1 February 2020 (date following first confirmed COVID-19 case in UK) and study end date (31 January 2021), allowing 1-year of follow-up. Planned analyses include multivariable Poisson, logistic and flexible parametric time-to-event regression within each country, adjusting for core predictors, followed by meta-analysis of country-specific results to produce combined effect estimates for the UK. Mediation analysis methods will be explored to examine the direct, indirect and mediated interactive effects between ethnicity, occupational group and COVID-19 outcomes.
Ethical approval for the UK-REACH programme has been obtained via the expedited HRA COVID-19 processes (REC ref: 20/HRA/4718, IRAS ID: 288316). Research information will be anonymised via the Secure Anonymised Information Linkage Databank before release to researchers. Study results will be submitted for publication in an open access peer-reviewed journal and made available on our dedicated website (https://uk-reach.org/).
ISRCTN11811602.
新冠病毒病（COVID-19）已在全球迅速传播，导致大量发病和死亡。少数族裔人群，尤其是在医疗环境中工作的人员，受到的影响尤为严重。目前，关于少数族裔与医疗环境中工作的人员的COVID-19结局之间关联的证据不足，无法为解决健康不平等问题的计划提供依据。
本研究将匿名的人力资源数据库与专业注册信息和国民医疗服务体系（National Health Service）数据集相结合，以评估英国医护人员的种族与COVID-19诊断、住院和死亡之间的关联。将在2020年2月1日（英国首例确诊COVID-19病例之后的日期）至研究结束日期（2021年1月31日）之间评估COVID-19的不良结局，随访期为1年。计划进行的分析包括在每个国家内进行多变量泊松回归、逻辑回归和灵活的参数生存时间回归，并对核心预测因素进行调整；随后对各国的具体结果进行荟萃分析，以得出英国的综合效应估计值。将探索中介分析方法，以研究种族、职业群体和COVID-19结局之间的直接、间接和中介交互效应。
UK-REACH项目已通过加速的健康研究管理局（HRA）COVID-19流程获得伦理批准（研究伦理委员会参考号：20/HRA/4718，IRAS识别号：288316）。在向研究人员发布之前，研究信息将通过安全匿名信息链接数据库进行匿名化处理。研究结果将提交至开放获取的同行评审期刊发表，并在我们的专用网站（https://uk-reach.org/）上公布。
ISRCTN11811602。
