Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jun 3:23:100404.
doi: 10.1016/j.eclinm.2020.100404. eCollection 2020 Jun.

The impact of ethnicity on clinical outcomes in COVID-19: A systematic review

Daniel Pan  1   2 , Shirley Sze  3 , Jatinder S Minhas  3 , Mansoor N Bangash  4   5 , Nilesh Pareek  6 , Pip Divall  7 , Caroline Ml Williams  1   2 , Marco R Oggioni  8 , Iain B Squire  3 , Laura B Nellums  9 , Wasim Hanif  10 , Kamlesh Khunti  11 , Manish Pareek  1   2
Affiliations

The impact of ethnicity on clinical outcomes in COVID-19: A systematic review

Daniel Pan et al. EClinicalMedicine. .

Abstract

Background: The relationship between ethnicity and COVID-19 is uncertain. We performed a systematic review to assess whether ethnicity has been reported in patients with COVID-19 and its relation to clinical outcomes.

Methods: We searched EMBASE, MEDLINE, Cochrane Library and PROSPERO for English-language citations on ethnicity and COVID-19 (1st December 2019-15th May 2020). We also reviewed: COVID-19 articles in NEJM, Lancet, BMJ, JAMA, clinical trial protocols, grey literature, surveillance data and preprint articles on COVID-19 in MedRxiv to evaluate if the association between ethnicity and clinical outcomes were reported and what they showed. PROSPERO:180654.

Findings: Of 207 articles in the database search, five reported ethnicity; two reported no association between ethnicity and mortality. Of 690 articles identified from medical journals, 12 reported ethnicity; three reported no association between ethnicity and mortality. Of 209 preprints, 34 reported ethnicity - 13 found Black, Asian and Minority Ethnic (BAME) individuals had an increased risk of infection with SARS-CoV-2 and 12 reported worse clinical outcomes, including ITU admission and mortality, in BAME patients compared to White patients. Of 12 grey literature reports, seven with original data reported poorer clinical outcomes in BAME groups compared to White groups.

Interpretation: Data on ethnicity in patients with COVID-19 in the published medical literature remains limited. However, emerging data from the grey literature and preprint articles suggest BAME individuals are at an increased risk of acquiring SARS-CoV-2 infection compared to White individuals and also worse clinical outcomes from COVID-19. Further work on the role of ethnicity in the current pandemic is of urgent public health importance.

Funding: NIHR.

Keywords: Covid-19; Ethnic; Ethnicity; Review; Sars-cov-2.

PubMed Disclaimer

Figures

Fig. 1:
Fig. 1
PRISMA Flow Diagram.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organization . 2020. Novel coronavirus - China.http://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/ (Accessed May 15)
    1. Yang X, Yu Y, Xu J. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;2600:1–7. - PMC - PubMed
    1. Graselli G, Pesenti A, Cecconi M. Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy. Early Experience and Forecast During an Emergency Response. JAMA. 2020 doi: 10.1001/jama.2020.4031. - DOI - PubMed
    1. Lee C. ‘Race’ and ‘ethnicity’ in biomedical research: How do scientists construct and explain differences in health? Soc Sci Med. 2009;68:1183–1190. - PubMed
    1. Bonham VL, Green ED, Perez-Stable EJ. Examining how race, ethnicity and ancestry data are used in biomedical resaerch. JAMA. 2018;320:1533–1534. - PMC - PubMed