Higher rates of severe COVID-19 infections in Black, Asian and Minority Ethnic (BAME) populations are not adequately explained by socioeconomic or behavioural factors, cardiovascular disease risk or by vitamin D status, according to a new UK research published in the Journal of Public Health.
Researchers studied 4510 UK Biobank participants tested for COVID-19 (positive: n=1326). Multivariate logistic regression models including age, sex and ethnicity were used to test whether the addition of (1) cardiometabolic factors (diabetes, hypertension, high cholesterol, prior myocardial infarction, smoking and body mass index [BMI]); (2) 25(OH)-vitamin D; (3) poor diet; (4) Townsend deprivation score; (5) housing (home type and overcrowding); or (6) behavioural factors (sociability and risk-taking) attenuated sex/ethnicity associations with COVID-19 status.
The results showed an over-representation of men and BAME ethnicities in the COVID-19-positive group. BAME individuals had, on average, poorer cardiometabolic profile, lower 25(OH)-vitamin D, greater material deprivation and were more likely to live in larger households and in flats/apartments, with higher Townsend deprivation scores.
Male sex and BAME ethnicity were independently associated with significantly greater odds of COVID-19 positivity: OR, 1.23 (95% CI, 1.08-1.41) and OR, 1.59 (95% CI, 1.26-1.99), respectively.
Every 1 kg/m2 increase in BMI was associated with 1.02 (95% CI, 1.01-1.03) greater odds of COVID-19 positivity, and for every additional person living in the same household, the odds increased by 1.09 (95% CI, 1.03-1.16).
The pattern of association was consistent for men and women; cardiometabolic, socio-demographic and behavioural factors did not attenuate sex/ethnicity associations.
Factors which underlie ethnic differences in COVID-19 may not be easily captured, and so investigation of alternative biological and genetic susceptibilities, as well as more comprehensive assessment of the complex economic, social and behavioural differences, should be prioritised, the study authors said.