Ethnic inequalities in positive SARS-CoV-2 tests, infection prognosis, COVID-19 hospitalisations, and deaths: analysis of two years of a record linked national cohort study in Scotland

Authors: Amele, Sarah;

Kibuchi, Eliud ;

McCabe, Ronan;

Pearce, Anna;

Henery, Paul M.;

Hainey, Kirsten J.;

Fagbamigbe, Adeniyi F. ;

Kurdi, Amanj ;

McCowan, Colin;

Simpson, Colin R. ;

Dibben, Chris;

Buchanan, Duncan;

Demou, Evangelia ;

Almaghrabi, Fatima;

Anghelescu, Gina;

Taylor, Harry;

Tibble, Holly ;

Rudan, Igor ;

Nazroo, James;

Bécares, Laia ;

Daines, Luke ;

Irizar, Patricia ;

Jayacodi, Sandra;

Pattaro, Serena;

Sheikh, Aziz ;

Katikireddi, Srinivasa Vittal

Source: Journal of Epidemiology and Community Health

Full text

: http://dx.doi.org/10.1136/jech-2023-220501

Abstract

Background: This study aims to estimate ethnic inequalities in risk for positive SARS-CoV-2 tests, COVID-19 hospitalisations and deaths over time in Scotland. Methods: We conducted a population-based cohort study where the 2011 Scottish Census was linked to health records. We included all individuals ≥16 years living in Scotland on March 1 ,2020, with follow-up to April 17, 2022. Self-reported ethnic group was taken from the Census and Cox proportion hazard models estimated hazard ratios (HRs) for COVID-19 infections, hospitalisations and deaths, adjusted for age, sex, and health board. We also conducted separate analyses for each of the four waves of COVID-19 to assess changes in risk over time. Findings: Of the 4,358,339 individuals analysed, 1,093,234 positive SARS-CoV-2 tests, 37,437 hospitalisations, and 14,158 deaths occurred. The risk of COVID-19 hospitalisation or death among ethnic minority groups was often higher for White Gypsy/Traveller (HR 2.21, 95% CI (1.61- 3.06)) and Pakistani 2.09(1.90-2.29) groups compared with White Scottish. The risk of COVID-19 hospitalisation or death following confirmed infection was particularly higher for White Gypsy/Traveller 2.55(1.81-3.58), Pakistani 1.75(1.59-1.73), and African 1.61(1.28-2.03) relative to White Scottish. However, COVID-19 related deaths following hospitalisation did not differ. The risk of COVID-19 outcomes for ethnic minority groups was higher in the first three waves compared to fourth wave. Interpretation: Most ethnic minority groups were at increased risk of adverse COVID-19 outcomes in Scotland, especially White Gypsy/Traveller and Pakistani. Ethnic inequalities persisted following community infection but not following hospitalisation, suggesting differences in hospital treatment are not substantially contributing to ethnic inequalities.

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This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

Cite as

Amele, S., Kibuchi, E., McCabe, R., Pearce, A., Henery, P., Hainey, K., Fagbamigbe, A., Kurdi, A., McCowan, C., Simpson, C., Dibben, C., Buchanan, D., Demou, E., Almaghrabi, F., Anghelescu, G., Taylor, H., Tibble, H., Rudan, I., Nazroo, J., Bécares, L., Daines, L., Irizar, P., Jayacodi, S., Pattaro, S., Sheikh, A. & Katikireddi, S. 2023, 'Ethnic inequalities in positive SARS-CoV-2 tests, infection prognosis, COVID-19 hospitalisations, and deaths: analysis of two years of a record linked national cohort study in Scotland', Journal of Epidemiology and Community Health. http://dx.doi.org/10.1136/jech-2023-220501

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DOI: http://dx.doi.org/10.1136/jech-2023-220501

Repository URI: https://strathprints.strath.ac.uk/86312/