Ethnicity and COVID-19 death in the early part of the COVID-19 second wave in England

Short report: Ethnicity and COVID-19 death in the early part of the COVID-19 second wave in England: an analysis of OpenSAFELY data from 1st September to 9th November 2020

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How to cite: Short report: Ethnicity and COVID-19 death in the early part of the COVID-19 second wave in England: an analysis of OpenSAFELY data from 1st September to 9th November 2020 Krishnan Bhaskaran, Rohini Mathur, Christopher T Rentsch, Caroline E Morton, William J Hulme, Anna Schultze, Brian MacKenna, Rosalind M Eggo, Angel YS Wong, Elizabeth J Williamson, Harriet Forbes, Kevin Wing, Helen I McDonald, Chris Bates, Seb Bacon, Alex J Walker, David Evans, Peter Inglesby, Amir Mehrkar, Helen J Curtis, Nicholas J DeVito, Richard Croker, Henry Drysdale, Jonathan Cockburn, John Parry, Frank Hester, Sam Harper, Ian J Douglas, Laurie Tomlinson, Stephen JW Evans, Richard Grieve, Liam Smeeth, Ben Goldacre medRxiv 2021.02.02.21250989; doi: https://doi.org/10.1101/2021.02.02.21250989

Abstract

Black and minority ethnic groups were at raised risk of dying from COVID-19 during the first few months of the COVID-19 epidemic in England. We aimed to investigate whether ethnic inequalities in COVID-19 deaths were similar in the more recent “second wave” of the epidemic. Working on behalf of NHS England, we used primary care and linked ONS mortality data within the OpenSAFELY platform. All adults in the database at 1st September 2020 and with at least 1 year of prior follow-up and a record of ethnicity were included. The outcome was COVID-19-related death (death with COVID-19 listed as a cause of death on the death certificate). Follow-up was to 9th November 2020. Hazard ratios for ethnicity were calculated using Cox regression models adjusted for age and sex, and then further adjusted for deprivation. 13,223,154 people were included. During the study period, people of South Asian ethnicity were at higher risk of death due to COVID-19 than white people after adjusting for age and sex (HR = 3.47, 95% CI 2.99-4.03); the association attenuated somewhat on further adjustment for index of multiple deprivation (HR = 2.86, 2.46-3.33, Table 2). In contrast with the first wave of the epidemic, we found little evidence of a raised risk in black or other ethnic groups compared to white (HR for black vs white = 1.28, 0.87-1.88 adjusted for age and sex; and 1.01, 0.69-1.49 further adjusted for deprivation). Our findings suggest that ethnic inequalities in the risk of dying COVID-19-related death have changed between the first and early second wave of the epidemic in England.