NEWS


Research to improve understanding of links between COVID-19 and ethnicity


The Medical Research Council (MRC) and the National Institute for Health Research (NIHR) have announced a multi-million- pound investment in six new projects to improve understanding of the links between COVID-19 and ethnicity. These projects will seek to explain and mitigate the disproportionate death rate from COVID-19 among people from Black, Asian and minority ethnic (BAME) backgrounds, including BAME health and social care workers.


Emerging evidence shows that,


after taking account of age and other sociodemographic factors, BAME people are nearly twice as likely to die of COVID-19 than white people. There is an urgent need for more detailed data on why COVID-19 disproportionately impacts people from BAME backgrounds, building the essential evidence base needed to make recommendations to decision makers and


protect the health of these groups. The projects, which total £4.3 million


worth of funding, will explore: the impact of the virus specifically on migrant and refugee groups; work with key voices within BAME communities to create targeted, digital health messages; the introduction of a new framework to ensure the representation of people from BAME backgrounds in clinical trials testing new treatments and vaccines for COVID-19; and the creation of one the UK’s largest COVID-19 cohorts.


One of the projects will establish a unique partnership between national healthcare organisations to specifically address the prevalence of COVID-19 among BAME healthcare workers who have been significantly overrepresented among the deaths from the virus. The mixed-method project will bring together existing datasets to calculate the risk of COVID-19 to all BAME healthcare workers and follow a group of these healthcare workers over the next 12 months to assess their physical and mental health, as well as engage directly with a smaller group of workers to gather qualitative data.


This group of projects forms part of a rolling call for research proposals on COVID-19, jointly funded by UKRI’s MRC and NIHR in response to the pandemic, and includes research on treatments, vaccines and the spread of the virus, as well as specific calls on COVID-19 and ethnicity, and the wider impact of the virus on mental health.


Men have 62% increased risk of


COVID mortality New research presented at the ESCMID Conference on Coronavirus Disease confirms that men with COVID-19 have worse outcomes than women, possibly related to them experiencing higher levels of inflammation. The study, by Dr. Frank Hanses, University Hospital Regensburg, Germany, and colleagues, shows that men have a significantly increased risk of COVID-19 associated death compared with women, after adjustment for various factors.


Male predominance was even more pronounced in the age groups >65 years and >75 years. Progression to a critical phase was seen more often in men than in women (30.6% vs 17.2%). Mean hospital length of stay was longer in male patients (15.4 vs 13.3 days). Both crude mortality (19.2% vs 12.9%) and COVID-19 attributable mortality (17.1% vs 10.3%), were significantly higher in men, while being male proved to be an independent risk factor for a 62% increased risk of COVID-19 associated death. Men also had significantly higher inflammatory markers across all phases of disease.


The authors concluded that these effects were not explained by differences in comorbidities, age or BMI between male and female patients.


Calls to ensure long term support for COVID-19 survivors


Healthcare systems around the world need to develop ways of supporting people in the community who are recovering from COVID-19, say researchers. If they don’t, there is a risk that people experiencing long-term symptoms will get worse and put additional strain on already-stretched health resources.


Although COVID-19 starts as an acute infection of the lungs, it can develop into a ‘multi-system illness’ leaving people with symptoms that can last for months and years, including breathlessness, fatigue, weakness, pain, cardiac problems, cognitive and psychological problems. More than one-third of the people who have been severely ill with the disease could have long-term symptoms, some of them debilitating. The study ‘Development of an integrated rehabilitation pathway for individuals recovering from COVID-19 in the community’, by experts from the University


OCTOBER 2020


of Leeds, Leeds Teaching Hospitals NHS Trust, Leeds Community Healthcare NHS Trust and NHS Leeds Clinical Commissioning Group, has been published in the Journal of Rehabilitation Medicine. Dr. Manoj Sivan, associate clinical professor at the University of Leeds and a consultant in rehabilitation medicine in the NHS Trusts, led the research project. He said: “We know from previous outbreaks of Spanish flu, SARS and Ebola that up to a third of survivors can suffer from long term problems, particularly chronic fatigue that has implications on family life, work and health economy. With COVID-19, there is an opportunity to intervene early, provide timely specialist rehabilitation, and ensure people have the best functional recovery and return to their vocation as early as possible.” The researchers describe a telephone screening and referral service that has


been pioneered by the Leeds COVID-19 rehabilitation teams at Leeds Teaching Hospitals and Leeds Community Healthcare NHS Trusts. People who have been severely ill with COVID-19 are contacted either by their GP or a specialist member of the hospital’s rehabilitation team six and 12 weeks after recovering from the acute phase of the illness. They are asked a series of questions and scored on any persistent symptoms and how well they are functioning.


The screening identifies symptoms that need to be urgently assessed by relevant specialist healthcare professionals in secondary or primary care services. Services include respiratory medicine, pulmonary rehabilitation, physiotherapy, occupational therapy, psychology or combined multidisciplinary clinics. Self-help resources have been developed, and NHS England is planning a website ‘Your COVID Recovery’.


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