Black and Asian people really are at higher risk of suffering severe Covid-19, England’s chief medical officer has confirmed.
Researchers at King’s College London (KCL) found new evidence that black people are more likely to be admitted to hospital with Covid, while Asian people are more at risk of dying in hospital from the virus.
The findings showed that black and mixed ethnicity patients have a three-fold higher risk of needing hospital admission once infected with Covid-19 compared with white people of the same area.
The new study provides answers to the much discussed question of why BAME people are hit harder by coronavirus and how.
Commenting on the new findings, Professor Chris Whitty said: “The evidence is now clear that people from Black and minority ethnic groups are more severely affected by COVID-19.
“This NIHR-supported research shows how different groups are affected, providing important information to help healthcare professionals offer the best possible treatment to minority ethnic patients.”
In the new study, KCL researchers confirmed that minority ethnic people bear a higher burden of Covid-19 than white patients.
They also discovered that black and Asian patients are affected at different stages of the disease.
Professor Ajay Shah, a cardiology expert at KCL, and consultant cardiologist at King’s College Hospital, said the findings are “striking” and suggest biological factors are at play.
He said: “The finding that black versus Asian patients are affected in quite different ways, and that significant risk persists even after adjustment for deprivation and long-term health conditions, is striking.
“It strongly suggests that other factors, possibly biological, are important and that we may need different treatment strategies for different ethnic groups.
“For black patients, the issue may be how to prevent mild infection progressing to severe whereas for Asian patients it may be how to treat life-threatening complications.”
The study looked at data from more than 1,800 adult patients admitted to King’s College Hospital, south east London, with a primary diagnosis of Covid-19 between March 1 and June 2 2020.
Researchers analysed mortality in this group and compared a subset of 872 admitted patients from inner south east London.
Among the patients, almost half (48.1 per cent) were black, a third (33.7 per cent) were white, slightly more than one in ten (12.6 per cent) were mixed and around one in twenty (5.6 per cent) were Asian ethnicity.
Almost 3,500 matched controls residing in the same region were used to determine how ethnic background is associated with the need for hospitalisation for severe disease.
Researchers found black and mixed ethnicity patients have a three-fold higher risk of needing hospital admission with Covid-19 compared to white inner-city residents of the same region.
This is only partly explained by underlying health conditions and deprivation as adjusting to these factors, black patients still have a 2.2 to 2.7-fold higher admission risk.
But their chances of survival in hospital was not significantly different from white patients.
By contrast, Asian patients did not have a higher risk of requiring hospital admission with COVID-19 than white patients but their in-hospital death rate and need for intensive care unit admission was higher than the other groups.
Researchers found that minority ethnic patients were ten to 15 years younger than white patients and had a higher prevalence of underlying health conditions, especially diabetes.
The study suggests that while underlying health conditions and socioeconomic factors contribute to the impact of COVID-19 on minority communities, there may be an important role for other factors such as biological factors which affect different subgroups in different ways.
The results of this study are likely to be applicable across the whole of London and similar UK cities, but more research is needed to translate to multi-ethnic populations in other countries.
Dr Sonya Babu-Narayan, associate medical director at the British Heart Foundation (BHF), said: “This study provides further evidence that COVID-19 disproportionally affects those whose ethnic background is a minority where they live, as has been seen across the world.
“Why coronavirus hits people with an ethnic minority background harder, and how to mitigate this, has been complex to address.
“People from Black, Asian and other Minority Ethnic backgrounds more often have heart and circulatory risk factors including high blood pressure and diabetes, and are more exposed to socioeconomic disadvantage.
“But this study indicates the worse effects of COVID-19 are present even after these are accounted for.
“Research is now needed to assess how other structural and behavioural factors may contribute, including occupation, access to health messaging and health care, and differences in the patient journey once people reach hospital.
“As we see COVID-19 cases rise again in the UK, we must address these disparities with urgency.”
Findings were published today (Fri) in the journal EClinicalMedicine, led by KCL researchers with support from the NIHR Guy’s and St Thomas’ Biomedical Research Centre and the BHF.
The study examines the relationship between ethnic background and the virus SARS-CoV-2.