Morgenstern Christian, Rawson Thomas, Hinsley Wes, Perez Guzman Pablo N, Bhatt Samir, Ferguson Neil M
MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK.
University of Copenhagen, Copenhagen, Denmark.
Sci Adv. 2025 May 23;11(21):eadu8678. doi: 10.1126/sciadv.adu8678. Epub 2025 May 21.
The impact of COVID-19 varied significantly by deprivation, ethnicity, and policy measures. We analyzed individual-level data on 12,310,485 first SARS-CoV-2 Pillar 2-PCR-confirmed infections, 439,083 hospitalizations, 107,823 deaths, and vaccination records in England from May 2020 to February 2022. Poisson regression models adjusted for demographic and temporal factors showed higher incidence rate ratios (IRRs) for severe outcomes in the most deprived areas compared to the least. We note higher IRRs for severe outcomes for all non-white relative to white ethnicities. The magnitude of IRRs for both deprivation and ethnicities declined from the wild-type to the omicron periods for severe outcomes. For infections, we observed IRRs above one for non-white ethnicities during the wild-type and alpha periods. Vaccination significantly reduced risks across all groups. For severe outcomes, preexisting health inequalities led to large and persistent disparities. For infections, measures must be structured with ethnicity and deprivation in mind early in a pandemic.
新冠疫情的影响因贫困程度、种族和政策措施而有显著差异。我们分析了2020年5月至2022年2月期间英格兰12310485例首次经第二支柱聚合酶链反应确诊的新冠病毒感染病例、439083例住院病例、107823例死亡病例以及疫苗接种记录的个体层面数据。经人口统计学和时间因素调整的泊松回归模型显示，与最不贫困地区相比，最贫困地区严重后果的发病率比值（IRRs）更高。我们注意到，所有非白人种族相对于白人种族而言，严重后果的发病率比值更高。从野生型到奥密克戎时期，贫困和种族导致严重后果的发病率比值幅度均有所下降。对于感染病例，我们观察到在野生型和阿尔法时期，非白人种族的发病率比值高于1。疫苗接种显著降低了所有群体的风险。对于严重后果，先前存在的健康不平等导致了巨大且持续的差异。对于感染病例，在疫情早期制定措施时必须考虑到种族和贫困因素。
