Association Between Race/Ethnicity and COVID-19 Disease Outcomes in the United States: A Qualitative Systematic Review of the Literature
Background/Objective: As studies have shown disparities in coronavirus disease-19 prevalence and severity, we sought to evaluate differences in outcomes of acute SARS-CoV-2 infection by race/ethnicity.
Design: Systematic review
Data Source: Studies from PubMed were included.
Review methods: Articles published in English language from January 1, 2019 through March 22, 2020. Studies included were observational studies that examined racial or ethnic disparities in SARS-CoV-2 infection outcomes in the United States. One reviewer performed data extraction.
Results: Out of a possible 1,944 articles, 99 observational studies (82 individual-level and 17 population-level) were included. Differential rates of hospitalization or otherwise severe illness (as indicated by intensive care unit admission, complications, and/or death) from coronavirus disease-19 (COVID-19) by race/ethnicity were reported, with many studies indicating higher rates of hospitalization for minority populations (particularly African American individuals) and results more mixed on differences in severe illness. Ecological studies showed associations between population-level proportion of minority residents and greater mortality from COVID-19. There were few studies examining racial differences in pediatric populations.
Conclusions: There are disparities in hospitalization for COVID-19, with non-Hispanic black and Hispanic individuals experiencing higher rates. This disparity is not consistently seen in case-fatality among individuals receiving care, suggesting that social and economic inequity, rather than individual biological factors, drive individual-level COVID-19 hospitalization, as well as mortality at the population level.
Smith, Jacob, "Association Between Race/Ethnicity and COVID-19 Disease Outcomes in the United States: A Qualitative Systematic Review of the Literature" (2021). MEDI 9331 Scholarly Activities Clinical Years. 44.