Ethnicity and COVID-19 cardiovascular complications: a multi-center UK cohort

BACKGROUND: Recent reports suggest an association between ethnicity and COVID-19 mortality In the present multi-center study, we aimed to assess the differences underlying this association, and ascertain whether ethnicity also mediates other aspects of COVID-19 like cardiovascular complications METHODS: Data were collected from a mixed-ethnicity UK cohort of 613 patients admitted and diagnosed COVID-19 positive, across six hospitals in London during the second half of March 2020: 292 were White Caucasian ethnicity, 203 were Asian and 118 were of Afro-Caribbean ethnicity RESULTS: Caucasian patients were older (P<0 001) and less likely to have hypertension (P=0 038), while Afro-Caribbean patients had higher prevalence of diabetes mellitus (P<0 001) Asian patients were more likely to present with venous thromboembolic disease (adj OR=4 10, 95% CI 1 49-11 27, P=0 006) On the other hand, Afro-Caribbean had more heart failure (adj OR=3 64, 95% CI 1 50-8 84, P=0 004) and myocardial injury (adj OR=2 64, 95% CI 1 10-6 35, P=0 030) Importantly, our adjusted multi-variate Cox regression analysis revealed significantly higher all-cause mortality both for Asian (adj HR=1 89, 95% CI 1 23-2 91, P=0 004) and Afro-Caribbean ethnicity (adj HR=2 09, 95% CI 1 30-3 37, P=0 002) CONCLUSIONS: Our data show that COVID-19 may have different presentations and follow different clinical trajectories depending on the ethnicity of the affected subject Awareness of complications more likely to arise in specific ethnicities will allow a more timely diagnosis and preventive measures for patients at risk Due to increased mortality, individuals of Afro-Caribbean and Asian ethnicity should be considered as high-risk groups This may have an impact on health-resource allocation and planning, definition of vulnerable groups, disease management, and the protection of healthcare workers at the frontline