A systematic review and meta-analysis of clinical outcomes following COVID-19 infection in ethnic minority groups in the UK

Objectives This systematic review and meta-analysis evaluated the clinical outcomes of COVID-19 disease in the ethnic minorities of the UK in comparison to the White ethnic group. Methods The study included adult residents of the UK with confirmed COVID-19. Outcomes evaluated were mortality, ICU admission, and invasive mechanical ventilation need in ethnic minorities compared to people from a White background. Medline, Embase, Cochrane, MedRxiv, and Prospero were searched for articles published between May 2020 to April 2021. Risk of bias was evaluated using the Newcastle-Ottawa Scale checklist. PROSPERO ID: CRD42021248117. Results Fourteen studies (767177 participants) were included in the review. In the adjusted analysis, the pooled Odds Ratio (OR) for the mortality outcome was higher for the Black (1.83, 95% CI: 1.21-2.76, number of studies: k=6), Asian (1.16, 95% CI: 0.85-1.57, k=6), and Mixed and Other (MO) groups (1.12, 95% CI: 1.04-1.20, k=5) in comparison to the White group. The adjusted and unadjusted ORs of intensive care admission were more than double for many of the ethnic minorities (OR Black 2.32, 95% CI: 1.73-3.11, k=5, Asian 2.34, 95% CI: 1.89-2.90, k=5, MO group 2.26, 95% CI: 1.64-3.11, k=4). In the adjusted analysis of mechanical ventilation need, the ORs were similarly significantly raised (Black group 2.03, 95% CI: 1.80-2.29, k=3, Asian group 1.84, 95% CI: 1.20-2.80, k=3, MO 2.09, 95% CI: 1.35-3.22, k=3). Conclusion This review found that in the UK, Black, Asian, and MO groups suffered from increased COVID-19 related disease severity and mortality compared to the White majority.