CoV-Ind-UK: Prospective investigation of the determinants for COVID-19 outcomes amongst South Asians in India and the United Kingdom.

South Asian people are at high risk both for infection with SARS-CoV2 virus, and for developing severe or fatal COVID-19. Addressing this inequality is a major public health priority. In this study, we will identify incident COVID-19, amongst ~30,000 South Asian men and women who are participants of our established prospective population studies in India and the UK. Participants will undergo testing for SARS-CoV2, and complete a validated questionnaire to assess symptoms, relevant behaviours, attitudes to vaccination, and adverse outcomes. We will use our available comprehensive baseline phenotypic data, including molecular characterisation and stored biological samples, collected before the COVID-19 pandemic, to determine what are the major risk factors for infection with SARS-CoV2, severe COVID-19, or prolonged COVID-19, amongst South Asians in India and the UK. We will focus initially on recognised risk factors such as adiposity, raised blood pressure, diabetes, cardiovascular disease, health behaviours, socio-economic indicators, and biochemical measures. We will compare our results in South Asians with equivalent data for Europeans, to determine whether these known risk factors explain the high risk of COVID-19 in Asians. We will develop simple tools for predicting risk of COVID-19 in South Asians, that can prioritise people for vaccination or behavioural interventions, and thus protect them from COVID-19. We will report on vaccine hesitancy in South Asians and the main reasons for this. Finally, we will use 'all-of-the-data', including available health and genetic data, to search for novel risk factors or biological processes that might contribute to COVID-19 in South Asians. Our research will thereby determine the reasons underlying the high burden of COVID-19 in South Asians and generate knowledge that will inform health policy and practice for prevention and control of the disease amongst South Asians in India, the UK and globally.