Ethnic differences in risk of severe Covid-19 : To what extent are they driven by exposure?

Edge, Rhiannon and van der Plaat, Diana and Parsons, Vaughan and Coggon, David and van Tongeren, Martie and Muiry, Rupert and cullinan, Paul and Madan, Ira (2022) Ethnic differences in risk of severe Covid-19 : To what extent are they driven by exposure? Journal of Public Health, 44 (4). pp. 787-796. ISSN 1741-3842

Text (Paper_2_Ethnicity_Manuscript_R1_clean_PC_final_accepted_)
Paper_2_Ethnicity_Manuscript_R1_clean_PC_final_accepted_.pdf - Accepted Version
Available under License Creative Commons Attribution-NonCommercial.
Download (322kB)

Abstract

BACKGROUND: This study quantifies the risk of Covid-19 among ethnic groups of healthcare staff during the first pandemic wave in England. METHODS: We analysed data on 959 356 employees employed by 191 National Health Service trusts during 1 January 2019 to 31 July 2020, comparing rates of Covid-19 sickness absence in different ethnic groups. RESULTS: In comparison with White ethnic groups, the risk of short-duration Covid-19 sickness absence was modestly elevated in South Asian but not Black groups. However, all Black and ethnic minority groups were at higher risk of prolonged Covid-19 sickness absence. Odds ratios (ORs) relative to White ethnicity were more than doubled in South Asian groups (Indian OR 2.49, 95% confidence interval (CI) 2.36-2.63; Pakistani OR 2.38, 2.15-2.64; Bangladeshi OR 2.38, 1.98-2.86), while that for Black African ethnicity was 1.82 (1.71-1.93). In nursing/midwifery staff, the association of ethnicity with prolonged Covid-19 sickness absence was strong; the odds of South Asian nurses/midwives having a prolonged episode of Covid-19 sickness absence were increased 3-fold (OR 3.05, 2.82-3.30). CONCLUSIONS: Residual differences in risk of short term Covid-19 sickness absences among ethnic groups may reflect differences in non-occupational exposure to SARS-CoV-2. Our results indicate ethnic differences in vulnerability to Covid-19, which may be only partly explained by medical comorbidities.