7 ms·
I think one of the key takeaways is in the abstract: > People from Asian and black groups are at markedly increased risk of in-hospital death from COVID-19, an
by lettergram 6y ago
I think one of the key takeaways is in the abstract:
> People from Asian and black groups are at markedly increased risk of in-hospital death from COVID-19, and contrary to some prior speculation is only partially attributable to pre-existing clinical risk factors or deprivation
- forgot_again 6y agoWhat does deprivation mean here? Early in the outbreak I remember seeing some research that indicated people of Asian descent (East Asian) are genetically predisposed to more severe cases of this coronavirus, something to do with higher expression of the ACE-2 receptor.
- loeg 6y agoIt means poor. It's unclear to me (only skimmed the figures) if the various ethnic/racial hazard factors correct for poverty (deprivation) or not.
- pacificmint 6y agoThey took that into consideration: > People from Asian and black groups are at markedly increased risk of in-hospital death from COVID-19, and contrary to some prior speculation this is only partially attributable to pre-existing clinical risk factors or deprivation;
- loeg 6y agoI noted that. However, "partially attributable" doesn't suggest to me one way or the other whether or not they corrected for that impact in figure 3. Or maybe I'm misreading the sentence.
- JPKab 6y agoDeprivation equals poverty. Asian in Britain will primarily be Indian/Pakistani descent. I wonder if this is vitamin d related? Darker complexion of black and Asian could cause higher risks of vitamin d deficiency in UK.
- eloff 6y agoVery likely it explains at least part of the difference.
- eloff 6y agoBecause obviously people with darker skins produce less vitamin D naturally and are more vitamin D deficient and all indications are that vitamin D deficiency is a big factor in Covid19 morality.
- peteretep 6y agoCould be dietary related too, or factors relating to multiple generations of families cohabiting. That said, these are prevalent in the sunny parts of Asia too, which doesn’t appear to be suffering so much, so my suspicion would be Vit-D related.
- dehrmann 6y agoSouth Asians and East Asians are pretty different genetically, so the lack of distinction really doesn't help.
- triplea9 6y agoIn the UK Asian == South Asian
- McP 6y agoSource? I've never got that impression as an English person. I consider it to be non-specific. However, if you're in a place like Southall or Bradford then the "Asian" people around you are indeed more likely to be south Asian.
- lazyasciiart 6y agohttps://en.wikipedia.org/wiki/British_Asian https://en.wikipedia.org/wiki/British_Asian
- TuringNYC 6y ago>> is only partially attributable to pre-existing clinical risk factors or deprivation I'd expect more it is attributable to less access to premium healthcare (remember, in the UK everyone gets healthcare, but not everyone gets privately-sponsored add-on healthcare)
- xhedley 6y agoUK privately-sponsored healthcare specialises in things that you cannot get free from the National Health Service or things where the wait time is long - for example knee surgery. People don’t use private healthcare for emergencies or intensive care. For example the prime minister was in intensive care in April - in an NHS hospital.
- tluyben2 6y agoSame in countries with public healthcare in the EU; when you have an emergency, you end up in public healthcare (which, in the countries I have lived in, is excellent), when you have a knee or hip operation, you benefit from private if you have it.
- 9HZZRfNlpR 6y agoIt would be surprising if in any EU country private clinics dealt with covid19 unless you're maybe super rich with personal doctors around you all the time.
- xhedley 6y agoReading the full paper, the population surveyed was people registered for at least one year with General Practice doctors using SystmOne software. That covers 40% of the English population. It is probably safe to assume that almost everyone in England is registered with a GP. There is variance in the GP use of the specific SystmOne software - the paper mentions on page 13 that only 17% of London GP practices use it.
- easytiger 6y agoThe quirk of the UK system is that private insurance companies have no legal or moral obligation to cover anything as you will always be able to fall back to the NHS. So getting cover than includes preexisting conditions or severe long term illness (e.g. MS) is very expensive and rarely negotiated by employers except in firms who can afford to do it.
- loeg 6y agoIt seems pretty remarkable that men have a hazard factor 2x that of women as well.
- elliekelly 6y agoThere was a post on HN a few days ago about a study that found low testosterone levels were correlated with worse Covid-19 outcomes. I think vitamin D is technically a hormone (or maybe is hormone-like?) so I wonder if it’s absorbed differently by men than women. Or maybe low testosterone is just a side effect of a vitamin D deficiency in men.
- sterlind 6y agoIt could also be low levels of sex hormones in general - having neither estrogen nor testosterone in your body causes osteoporosis, for example. Excess testosterone is metabolized into estrogen, as well. But the endocrine system is ferociously complex - maybe endocrine abnormalities are a proxy for obesity, or an underlying thyroid issue etc. According to [0], vitamin D deficiency is associated with higher free testosterone in men and lower estradiol in women. Higher testosterone is associated with cardiovascular problems, which are a big COVID risk factor. But that doesn't jib well with the study you find, so I dunno what to make of it. 0. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5218632/#__ffn_sectitle https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5218632/#__ffn_...
- rjsw 6y agoOne study suggested that progesterone was a factor in reducing viral levels.
- iddiid 6y agoI think that low testosterone levels is correlated with being older which is correlated with worse Covid-19 outcomes, so age is the important factor here.
- m463 6y agoMen also might have other factors compared to women. As an example 2x as many men vs women die in auto accidents.
- koheripbal 6y agoImportant to note that in UK parlance, "asian" usually encompasses middle-eastern and (I think) Indian ethnicities, whereas in the US is doesn't. This distinction might be important if there is some sort of vitamin-D/skin-melanin correlation to outcomes in northern latitudes.
- easytiger 6y agoThe UK BAME population is largely located in a couple of Large more densely populated cities. Whereas the country as a whole is around 87% white, London has areas with < 50% white people, for example Newham/Straford is 70% non white[1]. Surely the geographical relationship between dense cities and their inhabitants demographics is more than enough to explain it. [1] https://www.newham.info/population/ https://www.newham.info/population/