Association of Ethnicity and Socioeconomic Status With COVID-19 Hospitalization and Mortality in Those With and Without Chronic Kidney Disease

In the United Kingdom, as of December 2021, there have been more than 11.5 million confirmed cases of COVID-19 and more than 170,000 deaths caused by SARS-CoV-2.S1 Data are being reported on subpopulations most at risk of COVID-19 and its most severe forms. Age, ethnicity, and socioeconomic position—fundamental components in health inequality—strongly influence health outcomes for both infectious and noncommunicable diseases, and COVID-19 has further exposed the strong association between these and adverse health outcomes.1

There is substantial evidence that a disproportionate impact of COVID-19 exists on Black and South Asian ethnic groups.S2 Individuals from these groups are more likely to be infected by SARS-CoV-2 and have an increased risk of intensive care admission compared with those of White ethnicity.2 The mortality risk from COVID-19 among Black and Asian ethnic minority groups is approximately twice that of White patients.1,3 Socioeconomic status is also a key factor in COVID-19 outcome,4 and mortality rates from COVID-19 in the most deprived areas are more than double that of least deprived areas.5

Many of the ethnic and socioeconomic disparities that increase susceptibility to COVID-19 also make individuals vulnerable to chronic kidney disease (CKD). The risk of CKD is higher in ethnic minority groups compared with White individuals at every CKD stage,6 and CKD is associated with greater hospitalization and mortality from COVID-19.7,S3,S4 Although the etiology of CKD involvement is multifactorial,S3 the interactions with ethnic and socioeconomic status have not been studied. Previous data suggest that inequalities in COVID-19 deaths by ethnic group exist among people with similar pre-existing conditions, including CKD7; however, to our knowledge, no study has investigated how ethnicity and socioeconomic status affect COVID-19 severity among those with CKD.