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Is ethnicity linked to incidence or outcomes of COVID-19?

In a new paper published in the British Medical Journal (BMJ) on 20 April 2020, Kamlesh Khunti, Professor of primary care diabetes and vascular medicine and Dr Manish Pareek associate clinical professor in infectious diseases at the University of Leicester highlighted a number of reasons relating to higher incidence and severity of COVID-19 in minority.

Other factors such as an increased risk of admission for acute respiratory tract infections, vaccination policies in the country of birth and immunity effects, and higher prevalence of cardiovascular risk factors such as insulin resistance and obesity than white populations are also cited.

Professor Kamlesh Khunti said:

“The higher risk of COVID-19 in BAME populations is complex and may be associated with  socioeconomic, cultural, lifestyle factors,  genetic predisposition, or pathophysiological differences .

“To get a clearer picture of ethnic disparities in incidence and outcome in the UK, we need detailed national data reported by ethnic group.

 “We welcome the announcement that the NHS and Public Health England will lead a review of the evidence on why ethnic minority populations seem to be disproportionately affected by COVID-19.”

In addition, Professor Khunti highlighted possible social and cultural reasons that could explain a higher incidence of COVID-19, such as more people from BAME backgrounds living in poor overcrowded housing, living in extended cohabiting families and be employed in low paid essential jobs, which make social distancing challenging. All these factors could potentially increase the risk of virus transmission.

Professor Khunti continued:

“If an association is confirmed, further research will be needed to determine the causes. Meanwhile, populations of all ethnicities must continue handwashing and hygiene, social distancing and self-isolation when required. The public should also be encouraged to maintain healthy lifestyles to optimise cardiometabolic and mental health.”


Khunti, K., Singh, A.K., Pareek, M. and Hanif, W., 2020. Is ethnicity linked to incidence or outcomes of covid-19? BMJ 2020;369:m1548

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