‘Disproportionate rates’ of premature Covid-19 death in black and Asian patients

There have been disproportionate rates of premature death from Covid-19 among patients of Asian and black ethnicity, a large cohort study has found.

The research, published in the journal BMJ Open, is based on nearly 1,800 patients admitted to five acute hospitals within Barts Health NHS Trust between January 1 and May 13 2020.

The study found that patients from minority ethnic backgrounds were younger and less frail, compared with white patients.

It also showed that black patients were 1.8 times, and Asian patients 1.54 times, more likely to be admitted to an intensive care unit (ICU) and need mechanical ventilation.

Study author Dr Yize Wan, clinical lecturer at Queen Mary University of London and specialty registrar in intensive care medicine and anaesthesia at Barts Health NHS Trust, said: “Our study shows the disproportionate impact of Covid-19 on black and Asian groups in the first peak.

“Black and Asian people admitted to Barts Health hospitals with Covid-19 were significantly younger in age, had greater acute disease severity, and higher mortality relative to white patients of the same age and baseline health.

“As the impact of Covid-19 continues to be seen within our community, the importance of responding to the ethnic disparities unmasked during the Covid-19 pandemic is crucial to prevent entrenching and inflicting them on future generations.”

The clinicians looked at the data from 1,737 patients aged 16 and over who were admitted to hospital and had a confirmed Covid-19 diagnosis, 511 of whom died 30 days later.

The cohort comprised 538 (31%) Asian patients, 340 (20%) black patients, and 707 (40%) from white backgrounds.

Black and Asian ethnicity patients were significantly younger – with median ages of 64 and 59 respectively – compared with 73 in the white group, the researchers said.

In addition, both groups were found to be at 50%–80% increased risk of receiving mechanical ventilation in ICU, compared with white patients of a similar age.

After adjusting for factors such as age, sex, obesity, smoking and frailty, the researchers found that, compared with those from white backgrounds, Asian patients were 1.49 times, and black patients 1.3 times, more likely to die from Covid-19.

The experts said that while their study had a large number of patients, they were unable to get a more detailed ethnicity breakdown.

They said further research is needed to understand the reasons why those from Asian and black backgrounds have higher mortality from Covid-19 infection.

First author Dr Vanessa Apea, a consultant physician in sexual health and HIV at Barts Health NHS Trust and honorary senior lecturer at Queen Mary University of London, said: “Authentic community-based participatory research to understand the drivers of these differences, and co-creation of solutions are key to achieving health equity in these communities.”

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Categories: Asian, BAME, COVID-19, Deaths, disproportionality, News, Pandemic