EMBARGOED
Monday 21 June 2021 11:00
There are higher proportions of ethnic minority children in
England testing positive for COVID-19 than white children, with
Asian children more likely to be admitted to hospital with the
illness, finds an observational analysis of 2.6 million
healthcare records led by Oxford University researchers.
Reported today in JAMA Paediatrics, the largest population study
of COVID-19 in children to date suggests a link between ethnicity
and COVID-19, with important implications for global public
health strategies to combat the virus, such as access to tests.
In their study, a research team from the Universities of Oxford,
Leicester, Nottingham, Cambridge and Southampton analysed a
nationally-representative sample of 2,576,353 electronic
healthcare records in children to understand whether the
established link between ethnicity and COVID-19 in adults was
similar in children.
Overall, 410,726 (15.9% of the total cohort) children in the
analysis were tested for SARS-CoV-2, with 26,322 (6.4% of
children tested) receiving a positive test and 343 (0.01% of the
total cohort) admitted to hospital. The study found that COVID-19
testing in children varied across race and ethnicities - 17.1% of
white children in the study were tested for SARS-CoV-2 compared
with 13.6% of Asian children, 12.9% of children from mixed/other
ethnicities, and 8.3% of Black children.
Compared with white children, the odds of a positive test were
higher in children from Asian (1.8 times more likely), Black
(1.12 times more likely) and mixed/other ethnicity (1.14 times
more likely) backgrounds.
Asian children were 1.62 times more likely to be admitted to
hospital with confirmed COVID-19 compared with white children,
while Black, mixed race and children from other ethnicities were
more likely to remain in hospital for 36 hours or longer compared
with white children. There was one death in the study cohort.
Lead author Dr Defne Saatci, a DPhil student in the University of
Oxford’s Nuffield Department of Primary Care Health Sciences, who
conceived the project, said “This is the largest observational
study yet of COVID-19 in children, and highlights disparities in
testing, infection rates and hospitalisation linked to ethnic
minority children, with important implications for families,
doctors and policymakers.”
Co-author Professor Julia Hippisley-Cox, lead of the Primary Care
Epidemiology Group at Oxford University’s Nuffield Department of
Primary Care Health Sciences, said “While children are at a
substantially lower risk from COVID-19 compared with adults, this
study suggests that race and ethnicity play an important role in
outcomes for COVID-19 across all age groups. Our findings
reinforce the need for ethnicity-tailored approaches to
diagnosing and managing COVID-19 in community settings, so those
families at most risk of severe illness are better informed and
have greater access to tests.”
The observed unequal testing across different races and
ethnicities in this study supports similar findings from the US,
providing a clearer picture of inequity in healthcare access
across the two nations. In their analysis, the researchers
accounted for key demographic factors such as age, sex,
geography, deprivation and household size, in addition to
underlying health conditions. They caution that due to the
observational nature of the study certain biases could not be
ruled out, which should be considered before drawing any further
conclusions.
Data for the analysis was obtained between January and November
2020 from QResearch, a database of anonymised health records from
1,300 GP practices across England and linked to COVID-19 test
results and hospital admissions data. The research was funded
jointly by UK Research and Innovation and the National Institute
for Health Research.
Notes for Editors:
Paper reference: Association
between race/ethnicity and COVID-19 outcomes in 2.6 million
children in England.
