Association Between Ethnicity and Severe COVID-19 Disease: a Systematic Review and Meta-analysis.
J Racial Ethn Health Disparities
; 8(6): 1563-1572, 2021 12.
Article
en En
| MEDLINE
| ID: mdl-33180278
ABSTRACT
OBJECTIVES:
This article evaluates if ethnicity is an independent poor prognostic factor in COVID-19 disease.METHODS:
MEDLINE, EMBASE, Cochrane, WHO COVID-19 databases from inception to 15/06/2020 and medRxiv. No language restriction. Newcastle-Ottawa Scale (NOS) and GRADE framework were utilised to assess the risk of bias and certainty of evidence. PROSPERO CRD42020188421.RESULTS:
Seventy-two articles (59 cohort studies with 17,950,989 participants, 13 ecological studies; 54 US-based, 15 UK-based; 41 peer-reviewed) were included for systematic review and 45 for meta-analyses. Risk of bias was low median NOS 7 of 9 (interquartile range 6-8). Compared to White ethnicity, unadjusted all-cause mortality was similar in Black (RR 0.96 [95% CI 0.83-1.08]) and Asian (RR 0.99 [0.85-1.16]) but reduced in Hispanic ethnicity (RR 0.69 [0.57-0.84]). Age- and sex-adjusted risks were significantly elevated for Black (HR 1.38 [1.09-1.75]) and Asian (HR 1.42 [1.15-1.75]), but not for Hispanic (RR 1.14 [0.93-1.40]). Further adjusting for comorbidities attenuated these associations to non-significance:
Black (HR 0.95 [0.72-1.25]); Asian (HR 1.17 [0.84-1.63]); Hispanic (HR 0.94 [0.63-1.44]). Subgroup analyses showed a trend towards greater disparity in outcomes for UK ethnic minorities, especially hospitalisation risk.CONCLUSIONS:
This review could not confirm a certain ethnicity as an independent poor prognostic factor for COVID-19. Racial disparities in COVID-19 outcomes may be partially attributed to higher comorbidity rates in certain ethnicity.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Etnicidad
/
Gravedad del Paciente
/
COVID-19
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
J Racial Ethn Health Disparities
Año:
2021
Tipo del documento:
Article
País de afiliación:
Reino Unido