Authors’ reply: Ethnicity and clinical outcomes in COVID-19: A systematic review and meta-analysis

We thank Richard Armitage for his interest in our work. We agree that whilst our systematic review and meta-analysis shows the effect sizes for infection, intensive care admission and death amongst Black and Asian compared to White ethnicities were reduced in studies adjusting for confounders, our study also underscores that there are still not enough studies that disaggregate data on COVID-19 outcomes by ethnicity or adjust for key risk factors. Of the 227 studies we examined, only eight (4%) presented adjusted analyses for infection, four (2%) for ITU admission, and 18 (8%) for death. At least 147 (65%) studies could have disaggregated outcome data by ethnicity or presented adjusted analyses, but did not do so, significantly reducing our ability to interpret the driving factors for the higher risk in ethnic minority populations. [Opening paragraph]