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Ethnicity and clinical outcomes in COVID-19 A Systematic Review and Meta-analysis

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journal contribution
posted on 16.11.2020, 14:46 by Shirley Sze, Daniel Pan, Clareece Nevil, Laura Gray, Christopher Martin, Joshua Narareth, Jatinder Minhas, Pip Divall, Kamlesh Khunti, Laura Nellums, Manish Pareek
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.

History

Author affiliation

Department of Cardiovascular Sciences

Version

AM (Accepted Manuscript)

Published in

EClinicalMedicine

Publisher

Elsevier

issn

2589-5370

Acceptance date

26/10/2020

Copyright date

2020

Available date

12/11/2020

Language

en