The incidence of COVID-19-related hospitalisation in migrants in the UK: Findings from the Virus Watch prospective community cohort study

Wing Lam Erica Fong; Vincent G Nguyen; Rachel Burns; Yamina Boukari; Sarah Beale; Isobel Braithwaite; Thomas E Byrne; Cyril Geismar; Ellen Fragaszy; Susan Hoskins; Jana Kovar; Annalan Md Navaratnam; Youssof Oskrochi; Parth Patel; Sam Tweed; Alexei Yavlinsky; Andrew C Hayward; Robert W Aldridge

doi:10.1016/j.jmh.2024.100218

The incidence of COVID-19-related hospitalisation in migrants in the UK: Findings from the Virus Watch prospective community cohort study

J Migr Health. 2024 Feb 27:9:100218. doi: 10.1016/j.jmh.2024.100218. eCollection 2024.

Authors

Wing Lam Erica Fong¹, Vincent G Nguyen^{1

2

3}, Rachel Burns¹, Yamina Boukari¹, Sarah Beale^{1

2}, Isobel Braithwaite¹, Thomas E Byrne¹, Cyril Geismar^{2

4}, Ellen Fragaszy^{1

5}, Susan Hoskins², Jana Kovar¹, Annalan Md Navaratnam^{1

2}, Youssof Oskrochi¹, Parth Patel¹, Sam Tweed¹, Alexei Yavlinsky¹, Andrew C Hayward², Robert W Aldridge¹

Affiliations

¹ Institute of Health Informatics, University College London, London NW1 2DA, UK.
² Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK.
³ Department of Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK.
⁴ Department of Infectious Disease Epidemiology, MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London W2 1PG, UK.
⁵ Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.

Abstract

Background: Migrants in the United Kingdom (UK) may be at higher risk of SARS-CoV-2 exposure; however, little is known about their risk of COVID-19-related hospitalisation during waves 1-3 of the pandemic.

Methods: We analysed secondary care data linked to Virus Watch study data for adults and estimated COVID-19-related hospitalisation incidence rates by migration status. To estimate the total effect of migration status on COVID-19 hospitalisation rates, we ran mixed-effect Poisson regression for wave 1 (01/03/2020-31/08/2020; wildtype), and mixed-effect negative binomial regressions for waves 2 (01/09/2020-31/05/2021; Alpha) and 3 (01/06/2020-31/11/2021; Delta). Results of all models were then meta-analysed.

Results: Of 30,276 adults in the analyses, 26,492 (87.5 %) were UK-born and 3,784 (12.5 %) were migrants. COVID-19-related hospitalisation incidence rates for UK-born and migrant individuals across waves 1-3 were 2.7 [95 % CI 2.2-3.2], and 4.6 [3.1-6.7] per 1,000 person-years, respectively. Pooled incidence rate ratios across waves suggested increased rate of COVID-19-related hospitalisation in migrants compared to UK-born individuals in unadjusted 1.68 [1.08-2.60] and adjusted analyses 1.35 [0.71-2.60].

Conclusion: Our findings suggest migration populations in the UK have excess risk of COVID-19-related hospitalisations and underscore the need for more equitable interventions particularly aimed at COVID-19 vaccination uptake among migrants.

Keywords: COVID-19-related hospitalization; England; Migrant health; United Kingdom.