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Greater risk of severe COVID-19 in Black, Asian and Minority Ethnic populations is not explained by cardiometabolic, socioeconomic or behavioural factors, or by 25(OH)-vitamin D status: study of 1326 cases from the UK Biobank

Greater risk of severe COVID-19 in Black, Asian and Minority Ethnic populations is not explained by cardiometabolic, socioeconomic or behavioural factors, or by 25(OH)-vitamin D status: study of 1326 cases from the UK Biobank
Greater risk of severe COVID-19 in Black, Asian and Minority Ethnic populations is not explained by cardiometabolic, socioeconomic or behavioural factors, or by 25(OH)-vitamin D status: study of 1326 cases from the UK Biobank
Background
We examined whether the greater severity of coronavirus disease 2019 (COVID-19) amongst men and non-White ethnicities is explained by cardiometabolic, socio-economic, or behavioural factors.

Methods
We studied 4,510 UK Biobank participants tested for COVID-19 (positive, n=1,326). Multivariate logistic regression models including age, sex, and ethnicity were used to test whether addition of: 1)cardiometabolic factors (diabetes, hypertension, high cholesterol, prior myocardial infarction, smoking, BMI); 2)25(OH)-vitamin D; 3)poor diet; 4)Townsend deprivation score; 5)housing (home type, overcrowding); or 6)behavioural factors (sociability, risk taking) attenuated sex/ethnicity associations with COVID-19 status.

Results
There was over-representation of men and non-White ethnicities in the COVID-19 positive group. Non-Whites had, on average, poorer cardiometabolic profile, lower 25(OH)-vitamin D, greater material deprivation, and were more likely to live in larger households and flats/apartments. Male sex, non-White ethnicity, higher BMI, Townsend deprivation score, and household overcrowding were independently associated with significantly greater odds of COVID-19. The pattern of association was consistent for men and women; cardiometabolic, socio-demographic and behavioural factors did not attenuate sex/ethnicity associations.

Conclusions
Sex and ethnicity differential pattern of COVID-19 is not adequately explained by variations in cardiometabolic factors, 25(OH)-vitamin D levels, or socio-economic factors. Investigation of alternative biological pathways and different genetic susceptibilities is warranted.
1741-3842
451-460
Raisi-Estabragh, Zahra
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McCracken, Celeste
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Bethell, Mae S.
c3af4794-abd4-47d6-bf1c-c0ee84741184
Cooper, Jackie
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Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Caulfield, Mark J.
a13960ad-3f25-453e-a127-2913a935d73a
Munroe, Patricia B.
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Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Petersen, Steffen E.
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Raisi-Estabragh, Zahra
43c85c5e-4574-476b-80d6-8fb1cdb3df0a
McCracken, Celeste
5d772e9e-3aaa-41da-a5ef-3943b1631fd9
Bethell, Mae S.
c3af4794-abd4-47d6-bf1c-c0ee84741184
Cooper, Jackie
f78de577-4cac-496f-ad11-5f59dd305046
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Caulfield, Mark J.
a13960ad-3f25-453e-a127-2913a935d73a
Munroe, Patricia B.
44d23746-20cd-4572-860e-7350424cc031
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Petersen, Steffen E.
04f2ce88-790d-48dc-baac-cbe0946dd928

Raisi-Estabragh, Zahra, McCracken, Celeste, Bethell, Mae S., Cooper, Jackie, Cooper, Cyrus, Caulfield, Mark J., Munroe, Patricia B., Harvey, Nicholas and Petersen, Steffen E. (2020) Greater risk of severe COVID-19 in Black, Asian and Minority Ethnic populations is not explained by cardiometabolic, socioeconomic or behavioural factors, or by 25(OH)-vitamin D status: study of 1326 cases from the UK Biobank. Journal of Public Health, 42 (3), 451-460. (doi:10.1093/pubmed/fdaa095).

Record type: Article

Abstract

Background
We examined whether the greater severity of coronavirus disease 2019 (COVID-19) amongst men and non-White ethnicities is explained by cardiometabolic, socio-economic, or behavioural factors.

Methods
We studied 4,510 UK Biobank participants tested for COVID-19 (positive, n=1,326). Multivariate logistic regression models including age, sex, and ethnicity were used to test whether addition of: 1)cardiometabolic factors (diabetes, hypertension, high cholesterol, prior myocardial infarction, smoking, BMI); 2)25(OH)-vitamin D; 3)poor diet; 4)Townsend deprivation score; 5)housing (home type, overcrowding); or 6)behavioural factors (sociability, risk taking) attenuated sex/ethnicity associations with COVID-19 status.

Results
There was over-representation of men and non-White ethnicities in the COVID-19 positive group. Non-Whites had, on average, poorer cardiometabolic profile, lower 25(OH)-vitamin D, greater material deprivation, and were more likely to live in larger households and flats/apartments. Male sex, non-White ethnicity, higher BMI, Townsend deprivation score, and household overcrowding were independently associated with significantly greater odds of COVID-19. The pattern of association was consistent for men and women; cardiometabolic, socio-demographic and behavioural factors did not attenuate sex/ethnicity associations.

Conclusions
Sex and ethnicity differential pattern of COVID-19 is not adequately explained by variations in cardiometabolic factors, 25(OH)-vitamin D levels, or socio-economic factors. Investigation of alternative biological pathways and different genetic susceptibilities is warranted.

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covid2 mans SEP zre rvs - Accepted Manuscript
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More information

Accepted/In Press date: 3 June 2020
e-pub ahead of print date: 19 June 2020
Published date: September 2020

Identifiers

Local EPrints ID: 441219
URI: http://eprints.soton.ac.uk/id/eprint/441219
ISSN: 1741-3842
PURE UUID: 70058af5-f820-449a-8c9e-75e072214380
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 05 Jun 2020 16:31
Last modified: 26 Nov 2021 05:37

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Contributors

Author: Zahra Raisi-Estabragh
Author: Celeste McCracken
Author: Mae S. Bethell
Author: Jackie Cooper
Author: Cyrus Cooper ORCID iD
Author: Mark J. Caulfield
Author: Patricia B. Munroe
Author: Nicholas Harvey ORCID iD
Author: Steffen E. Petersen

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