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Oxford Study: Ethnic minority children may be disproportionately impacted by COVID-19

Ethnic minority children are at higher risk, with more testing positive than white children.

Higher proportions of ethnic minority children in England tested positive for coronavirus than white children – with Asian children more likely to be admitted to hospital, a new study led by Oxford University suggests.

While children mainly experience mild Covid-19, hospital admission rates are increasing, with limited understanding of underlying factors, researchers say.

There is an established association between race and severe Covid-19 outcomes in adults in England, however, whether a similar association exists in children had not been clear.

But new research suggests race may play an important role in childhood coronavirus outcomes.

In the study 2,5 76, 353 children (aged zero to 18) from participating family practices in England were identified in the QResearch database between January 24 and November 30, 2020.

The database has individually linked patients with national coronavirus testing, hospital admission, and mortality data.

Of these, 410,726 (15.9%) were tested for the virus and 26,322 (6.4%) tested positive.

A total of 1,853 children (0.07%) with confirmed Covid-19 attended hospital, 343 (0.01%) were admitted to the hospital, and 73 (0.002%) required intensive care.

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.

The study, published in Jama Paediatrics, found that 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, 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.”

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