Ethnic minority children in England are more likely to test positive for COVID-19 than white children, with Asian children more likely to be admitted to hospital with the illness, according to research by the University of Oxford using QResearch – a not-for-profit initiative between the university and EMIS.
The observational analysis of 2.6 million healthcare records - 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 the study, published in JAMA Paediatrics, the research team from the Universities of Oxford, Leicester, Nottingham, Cambridge and Southampton analysed a nationally-representative sample of children’s electronic healthcare records from the QResearch database 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. 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 than white children, while hospital stays in Black, mixed race and children from other ethnicities were around 36 hours longer than in white children. There was one death from COVID-19 in the study cohort.
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.”