First clinical review confirms BAME and COVID-19 link

Black, Asian and minority ethnic (BAME) individuals are at an increased risk of SARS-CoV-2 infection and adverse clinical outcomes, according to the first comprehensive systematic and review of published and unpublished data conducted by researchers at the University of Leicester.

169 records with original clinical data from 1st December 2019 and 15th May 2020 were reviewed in detail, which showed that individuals of Black and Asian ethnicity were at increased risk of infection with COVID-19, an increased risk of admission to intensive care unit when infected with COVID-19, and were at an increased risk of mortality when they had COVID-19.  

Published in the journal EClinical Medicine, and led by Dr Manish Pareek, Daniel Pan and Shirley Sze at the University of Leicester, this is the first time a systematic review of research studying the impact of ethnicity on COVID-19 has been conducted.

Dr Manish Pareek, Associate Clinical Professor in Infectious Diseases at the University of Leicester, said:

“This is the first systematic review to study ethnicity and COVID-19, and it shows that there is a link between ethnicity and an increased risk of SARS-CoV-2 infection as well as intensive care admission and mortality.

“Clarifying the role of ethnicity in the current pandemic is of urgent public health importance. Whilst there is insufficient data on the reasons that may contribute to increased risk of COVID-19 morbidity and mortality in ethnic minority groups, existing evidence does indicate a relationship between ethnicity and known risk factors for poor clinical outcomes in COVID-19.

“We know that the vast majority of NHS staff that have died have also been BAME. This review sends an important message to the NHS about protecting its vulnerable staff, and the Government to make this issue a priority.”

Although the exact reasons for the relationship between ethnicity and poor clinical outcomes in COVID-19 are not known, existing evidence does indicate that they are driven by both biological and socio-economic factors.

Cultural, behavioural and socio-economic differences among ethnic groups may influence how the virus spreads in an area – practices such as co-habiting in inter-generational familial units and occupational roles may have contributed to virus spread.

Dr Pareek has also called for the routine reporting of ethnicity data to build a better picture of the current situation. He says:

“Data in the published medical literature on ethnicity in patients with COVID-19 remains limited, and should be addressed through routine reporting of data on ethnicity as part of routine governmental surveillance data, large scale international registries and clinical trials.

“This will help to inform future public health interventions and further research.”