Critical Appraisal of a Published Article: Ethnicity and COVID-19

This report presents a critical appraisal of a published article focusing on "Ethnicity and outcomes in patients hospitalized with Covid-19 infections in East London: An observational cohort study." The appraisal examines the study's strengths, including its comprehensive approach to exploring COVID-19 outcomes in diverse ethnic populations and its analysis of socioeconomic and comorbid risk factors. The report also identifies limitations, such as the study's single-region focus and limited sample size for certain ethnic groups. The analysis covers substantive, theoretical, methodological, interpretative, ethical, and stylistic aspects of the article. It evaluates the study's contribution to public health intelligence, the soundness of its conceptual framework, the methods used for data collection and analysis, and the interpretation of the findings. Ethical considerations, stylistic organization, and the use of a CASP cohort checklist are also evaluated. The report concludes that the study highlights the varying impacts of COVID-19 based on factors like age and health conditions, emphasizing the role of obesity, comorbidities, and social determinants in health outcomes. The research provides valuable insights into ethnic inequalities in health outcomes, and the report provides the key findings of the research.

Critical Appraisal of a
Published article

TABLE OF CONTENT
INTRODUCTION ..........................................................................................................................3
Strength and limitation of this study ...........................................................................................3
A) Substantive..............................................................................................................................3
B) Theoretical..............................................................................................................................4
C) Methodological.......................................................................................................................4
D) Interpretative...........................................................................................................................5
E) Ethical.....................................................................................................................................5
F) Stylistic....................................................................................................................................6
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Critical appraisal is an systematical and careful examination related to specific topic in
order to judge its trustworthiness, value as well as relevance. It allows identification of most
relevant papers, reduce overload information by eliminating irrelevant studies and moreover
contribute in assessing the validity of the study. This report is aim to study the article based on
Ethnicity and outcomes in patients hospitalized with Covid-19 infections in East London: An
observational cohort study.
Strength and limitation of this study
The strength of the study can be evaluated that it is more comprehensive studies that
consists of exploring the outcome of Covid-19 in Asian, black and minority ethnic population.
Moreover, the study has focused evaluation of socioeconomic and comorbid risk factors
associated with Covid. Another strength of the study is that prespecified statistical analysis plan
and multiple sensitivity analysis has been used to test the robustness of finding of the study.
Proven cases were included in the study thus suspected diagnosis can be used in future studies.
On the other hand, the weakness of study is that it was majorly conducted in single region
in which impact of covid-19 was much more significant. Thereby it can be stated that it has not
confounded by regional concentration of minority ethnic groups and difference in incidences of
Covid-19 (Apea and et.al., 2021). Furthermore, it has been identified that the size of study was
wide but there was lack power to assess more detailed breakdown and like many data-set such as
Black african, Pakistani and Bangladeshi.
A) Substantive
Public health intelligence is an intellectual process of interpretation, analysis, processing
and generation of useful information that assist practitioners, policy-makers and clinicians in
taking decision related to better public health. The research problem was significant to public
health or public health intelligence because Covid-19 is diseases that has adversely impacted on
health and well-being of several individual that are residing in society. It has cause death to
number of people therefore the study will helps in finding necessary information related to topic
so that right decision can be taken by stakeholders. Such as through study it has been identified
that as per National health services and national statistics England described 2.5 fold to 4.3 fol
greater mortality rates in context of covid-19 as compared to range of South Asian and white
groups (Perez-Guzman, Daunt and Mukherjee, 2019). It helps in finding number of patient that

has been admitted in the hospital during the better lifestyles. Yes, the study has make important
contribution as it helps in finding increased risk of premature death, social deprivations and
independent of frailty that has caused due to impact of covid-19. Moreover, it has help in finding
out report related to outcome and treatment in context of covid-19 patients that has been
hospitalized in East London during the pandemic situation.
B) Theoretical
Conceptual framework explained about things that research is expecting to find by
conducting research on topic thus it define relevant variable and the way they are related to each
others. It can be stated that variable in the study were ethnicity that were divided into five high
level groups such as Asian, black, white, mixed and preserve statistical power and other
categories. Furthermore, in the study socioeconomic deprivation were assessed by making use of
English Indices of deprivation 2020 in order to compare or matching the patient postcode to
national Index of multiple deprivation (Russell and et.al., 2020.). Hospital frailty risk score and
baseline comorbid diseases were identified in order to map to ICD-10 coding. So all these
concepts or theoretical underpinning were sound as it helps in understanding the socioeconomic
deprivation that has been caused to due to impact of covid-19. All these contribute in gathering
necessary information so that right decision can be taken by individual related to public health
intervention.
C) Methodological
This is segment that specific about the several methods that has been used to gathered,
analysis and interpreted relevant information related to the study. Likewise for the article the
study population was all the patients that are confirmed SARCS-CoV-2 infections and admitted
between 1 January and 13 May 2020 within Barts Health NHS trust. At the same time people
that were under the age group of 16 years were not included in the study. The study has only
included patient that has been firstly emergency admitted as positive SARS-CoV-2 Test known
as index admission. Thus, it has not included community diagnoses that were not related to
emergency hospital admission thereby making research limited too some extend.
Data is collected from clinical, demographic, coding and blood collated from barts Health
cerner Millennium and all these analysis were performed by making use of RV. On the other
hand it can be illustrated that sensitivity analysis is also one of the method that has been used in
the study. It helps in determining the way different values of independent variable affects

specific dependent variable in context of set of assumptions. The advantages of sensitivity
analysis is that it contribute in-depth analysis, strengthen weak spots, proper allocation as well as
utilization of resources (Lassale and et.al., 2020). Moreover, it also provides advantages of better
decision-making and quality check so that right information can be given to various interested
stakeholders related to study. On the contrary note, there are certain disadvantages of sensitivity
analysis method such as it is based on assumptions, not relative in nature and only identified how
far variable needs to be changed thus does not look at probability of change.
D) Interpretative
From the article it can be interpreted that researchers has properly analyses data in order
to gathered useful information related to the topic so that correct decision can be made by
individual in future circumstances. Such as in the article the results has explained about the total
number of patients that is 1996 that are aged 16 years and older that were admitted in Barts
health admission before 13 may 2020. Table are used in the article to clearly represent the set of
population that has been used in order to pursue the study. The researchers have also provide
important information related to characteristics of population, intervention and outcomes across
ethnic groups. It has collect data that helps in understanding that risk factors related to Covid-19
varied on the basis of age of individuals, ethnicity within diabetes. Furthermore, it has contained
useful information related to critical care related outcome such as there are 11% of patient from
white group that were admitted to ICU as compared to 20.1% Asian and 18.5% of black group.
Therefore, it can be illustrated that researchers has adopted systematical applying logical
techniques or statistical in order to evaluate and analysis the data so that necessary information
can be derived (Aggarwal, 2020). At the same time it has ensure data integrity so that more
accurate and appropriate information can be analyses from the finding or study. Furthermore, the
articles has include comparison of finding with other studies such as predominant reports in USA
and UK. Likewise, as per the study South Asian communities have higher risk in Covid-19 as
compared to black background.
E) Ethical
This is elements which specify whether all ethical principles have been followed while
conducting the research by scholar so that study can be made more useful. From the article it can
be evaluated that all ethics has been abide such as right of study participants has been protected,
all have given equal opportunities. At the same time discrimination has been avoided to

maximum extend in order to get better information related to the topic and make article more
meaningful. The study was focused on unbiased population that consist of all patient pertaining
to specific religion that have much higher ethnic diversity. So, ethic has contributed in making
research paper more reliable and appropriate that can be easily trusted by people.s
F) Stylistic
The article on “Ethnicity and outcomes in patients Hospitalized with Covid-19 infections
in East London” has been systematically organized as it has clearly explained about aims,
objective of the research. Firstly it has specific the title of the article that helps in drawing
attention of the interested parties. Then it has given introduction which contained necessary
information related to background of the subject. Thirdly it has specified about method that has
been used to complete the study so that useful information can be gathered, analysis and
interpreted (Sá, 2020). Lastly, the articles has contained discussion of the topic and results that
has specified about the outcome that is drive from the study. Therefore, it can be stated that the
article was well-structured that will contribute in effectively study and useful of information in
better manner.
CASP COHORT CHECKLIST.
Did the study address clear focused issue? Yes
Have the author has addressed all relevant
points related to the study?
Yes
Was the outcome accurately measured to
minimized bias?
Yes
Was the exposure recruited in an acceptable
way?
Yes
Do the results gathered related to the study can
fit with other evidence
Cannot tell
Do you believe in the results Yes
How precise are the results Cannot tell
The results can be applied to local population Yes

CONCLUSION
It can be summarized from the above study that covid-19 has different impact on
different individuals depends upon various factors such as age, health condition of individuals.
Obesity and Comorbidity are two risk factors associated with wider social determinants like poor
living condition. At last, it can be concluded that the articles helps in understanding ethnic
inequalities on health outcomes.

REFERENCES
Books and Journals
Aggarwal, A., 2020. COVID-19 and ethnicity: Spotlight on the global rheumatology issues in
developing and developed countries.
Apea, V. J and et,.al., 2021. Ethnicity and outcomes in patients hospitalised with COVID-19
infection in East London: an observational cohort study. BMJ open, 11(1). p.e042140.
Lassale, C and et.al., 2020. Ethnic disparities in hospitalisation for COVID-19 in England: The
role of socioeconomic factors, mental health, and inflammatory and pro-inflammatory
factors in a community-based cohort study. Brain, behavior, and immunity, 88. pp.44-
49.
Perez-Guzman P N, Daunt A and Mukherjee S, 2019. Clinical characteristics and predictors of
outcomes ofhospitalised patients with COVID-19 in a London NHS trust: a
retrospective cohort study (29-04-2020) 2020.
Russell, B and et.al., 2020. Factors affecting COVID-19 outcomes in cancer patients: a first
report from Guy's Cancer Center in London. Frontiers in oncology, 10. p.1279.
Sá, F., 2020. Socioeconomic determinants of Covid-19 infections and mortality: evidence from
England and Wales.