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dc.contributor.authorSingh, Baldev M
dc.contributor.authorBateman, James
dc.contributor.authorViswanath, Ananth
dc.contributor.authorKlaire, Vijay
dc.contributor.authorMahmud, Sultan
dc.contributor.authorNevill, Alan M
dc.contributor.authorDunmore, Simon J
dc.date.accessioned2021-02-19T09:54:39Z
dc.date.available2021-02-19T09:54:39Z
dc.date.issued2021-02-17
dc.identifier.citationSingh BM, Bateman J, Viswanath A, et al. (2021) Risk of COVID-19 hospital admission and COVID-19 mortality during the first COVID-19 wave with a special emphasis on ethnic minorities: an observational study of a single, deprived, multiethnic UK health economy. BMJ Open 2021; 11:e046556. doi: 10.1136/bmjopen-2020-046556en
dc.identifier.issn2044-6055en
dc.identifier.doi10.1136/bmjopen-2020-046556en
dc.identifier.urihttp://hdl.handle.net/2436/623945
dc.description© 2021 The Authors. Published by BMJ. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: http://dx.doi.org/10.1136/bmjopen-2020-046556en
dc.description.abstractObjectives The objective of this study was to describe variations in COVID-19 outcomes in relation to local risks within a well-defined but diverse single-city area. Design Observational study of COVID-19 outcomes using quality-assured integrated data from a single UK hospital contextualised to its feeder population and associated factors (comorbidities, ethnicity, age, deprivation). Setting/participants Single-city hospital with a feeder population of 228 632 adults in Wolverhampton. Main outcome measures Hospital admissions (defined as COVID-19 admissions (CA) or non-COVID-19 admissions (NCA)) and mortality (defined as COVID-19 deaths or non-COVID-19 deaths). Results Of the 5558 patients admitted, 686 died (556 in hospital); 930 were CA, of which 270 were hospital COVID-19 deaths, 47 non-COVID-19 deaths and 36 deaths after discharge; of the 4628 NCA, there were 239 in-hospital deaths (2 COVID-19) and 94 deaths after discharge. Of the 223 074 adults not admitted, 407 died. Age, gender, multimorbidity and black ethnicity (OR 2.1 (95% CI 1.5 to 3.2), p<0.001, compared with white ethnicity, absolute excess risk of <1/1000) were associated with CA and mortality. The South Asian cohort had lower CA and NCA, lower mortality compared with the white group (CA, 0.5 (0.3 to 0.8), p<0.01; NCA, 0.4 (0.3 to 0.6), p<0.001) and community deaths (0.5 (0.3 to 0.7), p<0.001). Despite many common risk factors for CA and NCA, ethnic groups had different admission rates and within-group differing association of risk factors. Deprivation impacted only the white ethnicity, in the oldest age bracket and in a lesser (not most) deprived quintile. Conclusions Wolverhampton’s results, reflecting high ethnic diversity and deprivation, are similar to other studies of black ethnicity, age and comorbidity risk in COVID-19 but strikingly different in South Asians and for deprivation. Sequentially considering population and then hospital-based NCA and CA outcomes, we present a complete single health economy picture. Risk factors may differ within ethnic groups; our data may be more representative of communities with high Black, Asian and minority ethnic populations, highlighting the need for locally focused public health strategies. We emphasise the need for a more comprehensible and nuanced conveyance of risk.en
dc.formatapplication/pdfen
dc.language.isoenen
dc.publisherBMJen
dc.relation.urlhttps://bmjopen.bmj.com/content/11/2/e046556en
dc.subjectCovid-19en
dc.subjectethnicityen
dc.titleRisk of COVID-19 hospital admission and COVID-19 mortality during the first COVID-19 wave with a special emphasis on ethnic minorities: an observational study of a single, deprived, multiethnic UK health economyen
dc.typeJournal articleen
dc.identifier.journalBMJ Openen
dc.date.updated2021-02-18T10:26:28Z
dc.date.accepted2021-01-21
rioxxterms.funderUniversity of wolverhamptonen
rioxxterms.identifier.projectUOW19022021SDen
rioxxterms.versionVoRen
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc/4.0/en
rioxxterms.licenseref.startdate2021-02-19en
dc.source.volume11
refterms.dateFCD2021-02-19T09:54:07Z
refterms.versionFCDVoR
refterms.dateFOA2021-02-19T09:54:39Z


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