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    Ethnicity and clinical outcomes in COVID-19: A systematic review and meta-analysis

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    Author
    Sze, Shirley
    Pan, Daniel
    Martin, Christopher
    Nazareth, Joshua
    Minhas, Jatinder S
    Divall, Pip
    Pareek, Manish
    Keyword
    COVID-19
    Ethnic
    Ethnicity
    Race
    SARS-CoV-2
    Infection
    Systematic review
    Date
    2020-12
    
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    DOI
    https://doi.org/10.1016/j.eclinm.2020.100630
    Publisher's URL
    https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30374-6/fulltext
    Abstract
    Background: Patients from ethnic minority groups are disproportionately affected by Coronavirus disease (COVID-19). We performed a systematic review and meta-analysis to explore the relationship between ethnicity and clinical outcomes in COVID-19. Methods: Databases (MEDLINE, EMBASE, PROSPERO, Cochrane library and MedRxiv) were searched up to 31st August 2020, for studies reporting COVID-19 data disaggregated by ethnicity. Outcomes were: risk of infection; intensive therapy unit (ITU) admission and death. PROSPERO ID: 180654. Findings: 18,728,893 patients from 50 studies were included; 26 were peer-reviewed; 42 were from the United States of America and 8 from the United Kingdom. Individuals from Black and Asian ethnicities had a higher risk of COVID-19 infection compared to White individuals. This was consistent in both the main analysis (pooled adjusted RR for Black: 2.02, 95% CI 1.67-2.44; pooled adjusted RR for Asian: 1.50, 95% CI 1.24-1.83) and sensitivity analyses examining peer-reviewed studies only (pooled adjusted RR for Black: 1.85, 95%CI: 1.46-2.35; pooled adjusted RR for Asian: 1.51, 95% CI 1.22-1.88). Individuals of Asian ethnicity may also be at higher risk of ITU admission (pooled adjusted RR 1.97 95% CI 1.34-2.89) (but no studies had yet been peer-reviewed) and death (pooled adjusted RR/HR 1.22 [0.99-1.50]). Interpretation: Individuals of Black and Asian ethnicity are at increased risk of COVID-19 infection compared to White individuals; Asians may be at higher risk of ITU admission and death. These findings are of critical public health importance in informing interventions to reduce morbidity and mortality amongst ethnic minority groups.
    Citation
    Sze, S., Pan, D., Nevill, C. R., Gray, L. J., Martin, C. A., Nazareth, J., Minhas, J. S., Divall, P., Khunti, K., Abrams, K. R., Nellums, L. B., & Pareek, M. (2020). Ethnicity and clinical outcomes in COVID-19: A systematic review and meta-analysis. EClinicalMedicine, 29, 100630.
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/14946
    Collections
    Infectious Diseases
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