A preprint of a study released earlier this week has confirmed the increased risk of hospital death in people of south Asian backgrounds with Covid-19, and has started a look into the reasons why.
Since the early days of the Covid-19 outbreak, there have been reports of higher levels of deaths in people of colour. A Public Health England report looked into the links between ethnicity and outcomes of Covid-19, and showed that the risk of death is higher in people from black and Asian ethnic groups compared with white people.
The ISARIC CCP-UK Prospective Observational Cohort Study of Hospitalised Patients looked at data from 30,693 people admitted to 260 hospitals in England, Scotland and Wales between February and May 2020. There was no difference in severity of illness on admission. While just 5% of the people admitted had ethnicity reported as south Asian, people from this cohort were 19% more likely to die than white patients. People from all ethnic minorities were also more likely to need intensive care.
The increased rate of diabetes in the south Asian patient cohort compared with the white patients (40% vs 25%) could explain (at least in part) the increased risk of death. Type 2 diabetes has links with increased risk of death in hospital in people with Covid-19. In May 2020, an NHS England report showed that of the 23,804 people who had died in hospital as a result of a coronavirus infection, almost a third had a diagnosis of type 2 diabetes. When in hospital with Covid-19, people with type 2 diabetes are twice as likely to die than people who don't have diabetes.
The implications of the ISARIC CCP-UK study, as discussed by the authors, are that ethnicity should be accounted for in decisions about prevention, treatment and vaccination, and any disease-related guidance and policies should be developed with an awareness of the high percentage of south Asians in public-facing and key worker roles.
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