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Ethnicity and clinical outcomes in COVID-19: A systematic review and meta-analysis.
Sze, Shirley; Pan, Daniel; Nevill, Clareece R; Gray, Laura J; Martin, Christopher A; Nazareth, Joshua; Minhas, Jatinder S; Divall, Pip; Khunti, Kamlesh; Abrams, Keith R; Nellums, Laura B; Pareek, Manish.
  • Sze S; Department of Cardiovascular Sciences, University of Leicester, United Kingdom.
  • Pan D; Department of Respiratory Sciences, University of Leicester, United Kingdom.
  • Nevill CR; Department of Infection and HIV Medicine, University Hospitals Leicester NHS Trust, United Kingdom.
  • Gray LJ; Department of Health Sciences, University of Leicester, United Kingdom.
  • Martin CA; Department of Health Sciences, University of Leicester, United Kingdom.
  • Nazareth J; Department of Respiratory Sciences, University of Leicester, United Kingdom.
  • Minhas JS; Department of Infection and HIV Medicine, University Hospitals Leicester NHS Trust, United Kingdom.
  • Divall P; Department of Respiratory Sciences, University of Leicester, United Kingdom.
  • Khunti K; Department of Infection and HIV Medicine, University Hospitals Leicester NHS Trust, United Kingdom.
  • Abrams KR; Department of Cardiovascular Sciences, University of Leicester, United Kingdom.
  • Nellums LB; University Hospitals of Leicester, Education Centre Library, Glenfield Hospital and Leicester Royal Infirmary, United Kingdom.
  • Pareek M; Diabetes Research Centre, University of Leicester, United Kingdom.
EClinicalMedicine ; 29: 100630, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-919678
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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.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Language: English Journal: EClinicalMedicine Year: 2020 Document Type: Article Affiliation country: J.eclinm.2020.100630

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Language: English Journal: EClinicalMedicine Year: 2020 Document Type: Article Affiliation country: J.eclinm.2020.100630