Nuffield Department of Population Health, University of Oxford, Oxford, UK.
UK Biobank, Stockport, UK.
J Epidemiol Community Health. 2023 Dec 8;78(1):3-10. doi: 10.1136/jech-2023-220353.
The social determinants of ethnic disparities in risk of SARS-CoV-2 infection during the first wave of the pandemic in the UK remain unclear.
In May 2020, a total of 20 195 adults were recruited from the general population into the UK Biobank SARS-CoV-2 Serology Study. Between mid-May and mid-November 2020, participants provided monthly blood samples. At the end of the study, participants completed a questionnaire on social factors during different periods of the pandemic. Logistic regression yielded ORs for the association between ethnicity and SARS-CoV-2 immunoglobulin G antibodies (indicating prior infection) using blood samples collected in July 2020, immediately after the first wave.
After exclusions, 14 571 participants (mean age 56; 58% women) returned a blood sample in July, of whom 997 (7%) had SARS-CoV-2 antibodies. Seropositivity was strongly related to ethnicity: compared with those of White ethnicity, ORs (adjusted for age and sex) for Black, South Asian, Chinese, Mixed and Other ethnic groups were 2.66 (95% CI 1.94-3.60), 1.66 (1.15-2.34), 0.99 (0.42-1.99), 1.42 (1.03-1.91) and 1.79 (1.27-2.47), respectively. Additional adjustment for social factors reduced the overall likelihood ratio statistics for ethnicity by two-thirds (67%; mostly from occupational factors and UK region of residence); more precise measurement of social factors may have further reduced the association.
This study identifies social factors that are likely to account for much of the ethnic disparities in SARS-CoV-2 infection during the first wave in the UK, and highlights the particular relevance of occupation and residential region in the pathway between ethnicity and SARS-CoV-2 infection.
在英国大流行第一波期间，导致 SARS-CoV-2 感染风险在族裔之间出现差异的社会决定因素仍不清楚。
2020 年 5 月，从一般人群中招募了总共 20195 名成年人参加英国生物银行 SARS-CoV-2 血清学研究。在 2020 年 5 月中旬至 11 月中旬期间，参与者每月提供血液样本。在研究结束时，参与者完成了一份关于大流行不同时期社会因素的问卷。使用 2020 年 7 月采集的血液样本（在第一波疫情之后立即），通过逻辑回归得出了族裔与 SARS-CoV-2 免疫球蛋白 G 抗体（表明先前感染）之间关联的比值比（OR）。
排除后，有 14571 名参与者（平均年龄 56 岁，58%为女性）在 7 月返回了一份血液样本，其中 997 人（7%）具有 SARS-CoV-2 抗体。血清阳性与族裔密切相关：与白人相比，黑人、南亚人、中国人、混血人和其他族裔的 OR（调整年龄和性别后）分别为 2.66（95%CI 1.94-3.60）、1.66（1.15-2.34）、0.99（0.42-1.99）、1.42（1.03-1.91）和 1.79（1.27-2.47）。对社会因素的进一步调整使族裔的总体似然比统计减少了三分之二（67%；主要来自职业因素和英国居住地区）；对社会因素进行更精确的测量可能会进一步减少这种关联。
本研究确定了可能导致英国大流行第一波期间 SARS-CoV-2 感染在族裔之间出现差异的社会因素，并强调了职业和居住地区在族裔与 SARS-CoV-2 感染之间的关系中的特殊重要性。
