COVID hospitalisation, ethnicity
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New research explores the link between ethnicity and ESKD, which finds that Afro-Caribbean patients are four times more likely to undergo COVID hospitalisation

End-stage kidney disease (ESKD) is the last stage of long-term, chronic kidney disease. This is when your kidneys can no longer support your body’s needs, and is often caused by high blood pressure or diabetes. Chronic kidney disease often leads to ESKD, after a period of 10 to 20 years in which the kidney slowly fails to function.

The solutions to this kidney disease are dialysis or even a transplant – however, a special diet and medicines may also be necessary to re-create a functional organ.

The link between Afro-Caribbean ethnicity and COVID

Researchers throughout the COVID pandemic have been isolating ethnicity in tandem to COVID. Dr Manish Pareek, Associate Clinical Professor in Infectious Diseases at the University of Leicester, a senior author on a different study, said: “Our findings suggest that the disproportionate impact of COVID-19 on Black and Asian communities is mainly attributable to increased risk of infection in these communities.

“Many explanations exist as to why there may be an elevated level of COVID-19 infection in ethnic minority groups, including the greater likelihood of living in larger household sizes comprised of multiple generations; having lower socioeconomic status, which may increase the likelihood of living in overcrowded households; and being employed in frontline roles where working from home is not an option.”

This study drew from over 1,500 articles, collecting the information of more than 18 million people across the UK and the USA. Black people were found to be twice as likely to be infected, in comparison to people of white ethnicity. Asian people were found to be 1.5 times as likely as white people to catch COVID-19 – but Asian people were also the most likely ethnic group to end up in ICU and die from COVID-19.

‘Four-fold increased risk of being hospitalised’

Research published today (19 November) in Nephrology by King’s College London and Guy’s and St Thomas’ NHS Foundation Trust investigated the link between ethnicity and ESKD. They found patients of Afro-Caribbean ethnicity have a four-fold increased risk of COVID hospitalisation when compared to kidney transplant patients attending for routine care.

The study examined 39 people with diabetes related ESKD hospitalised with COVID-19 at Guy’s and St Thomas’ between March and April 2020. Of the hospitalised cohort, 73% of patients with a kidney transplant and 54% of haemodialysis patients were of Afro-Caribbean ethnicity. By comparison in patients attending hospital for routine care 18% of kidney transplant patients and 42% of haemodialysis patients are of Afro-Caribbean ethnicity.

The study concluded that ESKD is associated with a high mortality rate of 36%, among severely ill patients hospitalised with COVID-19.

‘People with ESKD are a high-risk group’ for COVID hospitalisation

Senior author, Dr Janaka Karalliedde from King’s College London, said: “People with ESKD are a high-risk group and are vulnerable to severe COVID-19 infection. When we compared the prevalence of Afro-Caribbean ethnicity in kidney transplant patients admitted with severe COVID-19 to the population of transplant patients attending for routine care at our hospital we observed a more than a four-fold increase in patients of Afro-Caribbean origin being admitted with COVID-19.

“Further studies and research are urgently required to understand and explain this observation of disproportionate risk in patients of Afro-Caribbean origin.

“Our data also confirm that the management of diabetes in the setting of severe COVID-19 infection is very challenging and reinforce the importance of integrated multidisciplinary care and teamwork for patients with diabetes hospitalized with COVID-19.”

Read the study here.


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