Socio-demographic heterogeneity in the prevalence of COVID-19 during lockdown is associated with ethnicity and household size: Results from an observational cohort study

Abstract

Background Accumulating evidence indicates that COVID-19 causes adverse outcomes in ethnic minority groups. However, little is known about the impact of ethnicity and household size on acquiring infection with SARS-CoV-2. Methods We undertook a retrospective cohort study, in Leicester (UK), of all individuals assessed for COVID-19 with polymerase chain reaction (PCR) testing at University Hospitals of Leicester NHS Trust between 1st March and 28th April 2020. We used logistic regression to identify sociodemographic, clinical and temporal factors associated with SARS-CoV-2 PCR positivity before/after lockdown. Findings 971/4051 (24.0%) patients with suspected COVID-19 were found to be PCR positive for SARS-CoV-2. PCR positivity was more common amongst individuals from ethnic minortiy backgrounds than their White counterparts (White 20.0%, South Asian 37.5%, Black 36.1%, Other 32.2%; p <0.001 for all ethnic minority groups vs White). After adjustment, compared to White ethnicity, South Asian (aOR 2.44 95%CI 2.01, 2.97), Black (aOR 2.56 95%CI 1.71, 3.84) and Other (aOR 2.53 95%CI 1.74, 3.70) ethnicities were more likely to test positive, as were those with a larger estimated household size (aOR 1.06 95%CI 1.02, 1.11). We saw increasing proportions of positive tests in the three weeks post-lockdown amongst the ethnic minority , but not the White, cohort. Estimated household size was associated with PCR positivity after, but not before, lockdown (aOR 1.10 95%CI 1.03, 1.16). Interpretation In individuals presenting with suspected COVID-19, those from ethnic minority communities and larger households had an increased likelihood of SARS-CoV-2 PCR positivity. Pandemic control measures may have more rapid impact on slowing viral transmission amongst those of White ethnicity compared to ethnic minority groups, Research is urgently required to understand the mechanisms underlying these disparities and whether public health interventions have differential effects on individuals from ethnic minority groups. Funding

Ethnicity and clinical outcomes in COVID-19: A systematic review and meta-analysis

“…A total of 18,728,893 patients from 50 papers were included in the meta-analyses after excluding any missing data within the studies; 14,506,023 (77%) were White; 1,267,802 (7%) were Asian; 527,944 (3%) were Black, 1,578,192 (8%) were Hispanic, 1,113 were Native American, 229,822 (2%) were Mixed, and 617,997(3%) were of Other ethnic group [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , 81] .…”

“…SARS-CoV-2 is much more efficiently spread in enclosed and crowded environments [62] . Individuals from ethnic minority backgrounds are more likely to live in larger household sizes comprised of multiple generations [ 26 , 63 ]. They are also more likely to have lower socioeconomic status, which may increase the likelihood of living in overcrowded households, or accommodation with shared facilities or communal areas [ 64 , 65 ].…”

Socio-Economic Instance of Ethnic Group in Bangladesh: A Case Study of Dhaka City

“…Analysis by Darlington, Norman, Ballas, and Exeter (2015) unfolds that while a dissimilarity by health issues are detected, the ethnic incongruity in health is deeply rooted in socioeconomic differences. This can be comprehended in the present context when in their research Martin, Jenkins, Minhas, Gray, Tang, Williams, and Knapp (2020) demonstrated that aggregated documentation reflects, ethnic minority groups are being largely affected by COVID-19 having an increased likelihood of SARS-CoV-2 PCR positivity.…”

Cross-Country Analysis of Funding Models of Medical Organizations in the Context of the COVID-19 Pandemic

“…В ряде стран до объявления Всемирной организации здравоохранения (ВОЗ) введены ограничения на перемещения и посещения общественных мест. С начала распространения коронавирусной инфекции системы здравоохранения в разных странах в течение короткого времени переориентировались на оказание ме-дицинской помощи в основном больным COVID-19 (Yu et al 2020, Iqbal et al 2020Martin et al 2020). В основном это выразилось в приостановлении оказания плановой медицинской помощи в стационарных условиях и ограничениях по приёмам в первичном амбулаторном звене.…”