Variations in cardiometabolic factors, vitamin D levels and socioeconomic or behavioural factors do not adequately explain why severe COVID-19 disproportionately affects black, Asian and minority ethnic (BAME) populations, according to research published in the Journal of Public Health (19 June 2020)
Investigators from Queen Mary University of London studied 4,510 UK Biobank participants who had been tested for COVID-19 — 1,326 (29.4%) of whom tested positive. They used multivariate logistic regression models, including age, sex and ethnicity, to test whether the addition of cardiometabolic factors (such as diabetes, hypertension or high cholesterol), vitamin D levels, poor diet, deprivation, housing or behavioural factors attenuated sex or ethnicity associations with COVID-19 status.
It was found that BAME ethnicity, male sex, higher body mass index, greater material deprivation and household overcrowding were independent risk factors for COVID-19. However, augmented risk in BAME populations was non-uniform, disproportionately affecting people of black and Asian ethnicities.
The ethnicity differential pattern of COVID-19 was not adequately explained by variations in cardiometabolic factors, vitamin D levels, or socioeconomic or behavioural factors. This, the researchers said, suggests that alternative biological pathways or genetic susceptibilities may have importance in driving the higher rates of severe COVID-19 in BAME populations and should be investigated.
“More comprehensive assessment of the complex economic, social and behavioural differences is [also] warranted”, the authors added.