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People of Black and Asian ethnicity up to twice as likely to be infected with COVID-19 as those of White ethnicity

Published: 12 November 2020

People of Black ethnicity are twice as likely to be infected with COVID-19 compared to those of White ethnicity, according to new research supported by the NIHR.

In addition, people of Asian ethnicity are 1.5 times more likely to become infected with the virus compared to people of White ethnicity. 

The study, supported by the NIHR Leicester Biomedical Research Centre, consisted of a systematic review of all evidence in scientific publications with data on the effect of ethnicity on clinical outcomes in patients with COVID-19. 

This study, the first systematic review on this topic, screened over 1500 articles to ultimately pool data from more than 18 million people who had taken part in 50 studies in the United Kingdom and United States of America.

All the patients included in the study had COVID-19, as defined by a positive nasal swab test or clinical signs and symptoms of the virus, along with radiology and laboratory tests.

Dr Manish Pareek, Associate Clinical Professor in Infectious Diseases at the University of Leicester, Consultant in Infectious Diseases at the University Hospitals of Leicester NHS Trust and a senior author on the paper, said: “Our findings suggest that the disproportionate impact of COVID-19 on Black and Asian communities is mainly attributable to increased risk of infection in these communities.”

Researchers also found that people of Asian ethnicities were at higher risk of admission to an intensive therapy unit (ITU) and of death. 

However, not all the studies investigating ITU admission included in the meta-analysis had been peer reviewed, and the risk of death was only of borderline statistical significance. This is in contrast to the strong evidence of increased risk of infection in Black and Asian ethnic groups shown in the study, published in EClinical Medicine by The Lancet.   

Dr Manish Pareek explained: “Many explanations exist as to why there may be an elevated level of COVID-19 infection in ethnic minority groups, including the greater likelihood of living in larger household sizes comprised of multiple generations; having lower socioeconomic status, which may increase the likelihood of living in overcrowded households; and being employed in frontline roles where working from home is not an option.”

Dr Shirley Sze, NIHR Academic Clinical Lecturer and Specialist Registrar in Cardiology at the University of Leicester and a lead author of the paper, said: “The clear evidence of increased risk of infection amongst ethnic minority groups is of urgent public health importance – we must work to minimise exposure to the virus in these at-risk groups by facilitating their timely access to healthcare resources and target the social and structural disparities that contribute to health inequalities.” 

The NIHR has funded five other research studies investigating the higher COVID-19 risk among Black, Asian and minority ethnic (BAME) groups. Another study carried out by NIHR researchers found that people from these ethnic groups were more likely to be hospitalised with COVID-19 infection.

Researchers are trying to encourage greater involvement from BAME groups in COVID-19 research to ensure any vaccines developed will work on as many people as possible. Additionally, the NIHR is engaging with patients and public members from BAME groups and supporting researchers with inclusive research.


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