Are ethnic disparities in COVID-19 severe outcomes over? Analysis of 5.3 million individuals in England and Wales from 2020-2022

To study ethnic disparities in risk of severe COVID-19 outcomes, we estimated age-standardised incidence rates and adjusted hazard ratios for 28-day mortality and 30-day cardiovascular disease (CVD) for individual ethnic groups from England and Wales. We studied 6-census-based ethnicity groups classification, 10-level classification (only for Wales), and 19-level classification along with additional sub-groups comprising > 1000 individuals each (only for England). COVID-19 mortality and CVD risk was increased in most non-White ethnic groups in England and Asian population in Wales during the 2.5 years after the pandemic outbreak. English data show mortality decreased during the Omicron variant's dominance, whilst CVD risk remained elevated for certain ethnic groups when compared to White populations (men: 58% Pakistani, 120% White and Asian, and 17% Any other White background; women: 75% Bangladeshi, 55% Caribbean, and 82% Any Other Ethnic Group). Ethnically diverse populations remained disproportionately affected by CVD throughout and beyond the COVID-19 pandemic.