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OP124 Ethnic inequalities in SARS-CoV-2 infections, infection prognosis, COVID-19 hospitalisations, and deaths: Analysis of two years of a record linked national cohort study in Scotland
  1. Sarah Amele1,
  2. Eliud Kibuchi1,
  3. Ronan McCabe1,
  4. Anna Pearce1,
  5. Paul Henery2,
  6. Kirsten Hainey1,
  7. Adeniyi Francis Fagbamigbe3,
  8. Amanj Amanj Kurdi4,
  9. Colin McCowan5,
  10. Colin R Colin R6
  1. 1MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
  2. 2Public Heath Scotland, Glasgow, UK
  3. 3Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
  4. 4Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, UK
  5. 5School of Medicine, University of St Andrews, St Andrews, UK
  6. 6Usher Institute, University of Edinburgh, Edinburgh, UK


Background This study aims to estimate ethnic inequalities in risk for SARS-CoV-2 infections, COVID-19 hospitalisations and deaths over time in Scotland.

Methods We conducted a population-based cohort study where the 2011 Scottish Census was linked to health records. We included all individuals 16 years living in Scotland on March 1 ,2020, with follow-up to April 17, 2022. Self-reported ethnic group was taken from the Census and Cox proportion hazard models estimated hazard ratios (HRs) for COVID-19 infections, hospitalisations and deaths, adjusted for age, sex, and health board. We also conducted separate analyses for each of the four waves of COVID-19 to assess changes in risk over time.

Results Of the 4,358,339 individuals analysed, 1,093,234 SARS-CoV-2 infections, 37,437 hospitalisations, and 14,158 deaths occurred. The risk of COVID-19 hospitalisation or death among ethnic minority groups was often higher for White Gypsy/Traveller (HR 2.21, 95% CI (1.61- 3.06)) and Pakistani 2.09 (1.90–2.29) groups compared with White Scottish. The risk of COVID-19 hospitalisation or death following confirmed infection was particularly higher for White Gypsy/Traveller 2.55(1.81–3.58), Pakistani 1.75(1.59–1.73), and African 1.61(1.28–2.03) relative to White Scottish. However, COVID-19 related deaths following hospitalisation did not differ. The risk of COVID-19 outcomes for ethnic minority groups was higher in the first three waves compared to fourth wave.

Conclusion Most ethnic minority groups were at increased risk of adverse COVID-19 outcomes in Scotland, especially White Gypsy/Traveller and Pakistani groups. Ethnic inequalities persisted following community infection but not following hospitalisation, suggesting differences in hospital treatment are not substantially contributing to ethnic inequalities.

  • COVID-19
  • SARS-CoV-2
  • ethnicity
  • race
  • ethnic inequalities

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