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Clinical Severity on Hospital Admission for COVID-19: An Analysis of Social Determinants of Health From an Early Hot Spot in the Southeastern U.S.
Chastain, Daniel B; Osae, Sharmon P; Thomas, Geren M; Burt, Ashley M; Rao, Amy; Henao-Martínez, Andrés F; Franco-Paredes, Carlos; Waller, Jennifer L; Young, Henry N.
  • Chastain DB; University of Georgia College of Pharmacy, Albany, GA, USA.
  • Osae SP; University of Georgia College of Pharmacy, Albany, GA, USA.
  • Thomas GM; John D. Archbold Memorial Hospital, Thomasville, GA, USA.
  • Burt AM; Colquitt Regional Medical Center, Moultrie, GA, USA.
  • Rao A; University of Colorado School of Medicine, Aurora, CO, USA.
  • Henao-Martínez AF; University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
  • Franco-Paredes C; University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
  • Waller JL; Hospital Infantil de México, Federico Gómez, México City, México.
  • Young HN; Augusta University, Augusta, GA, USA.
J Prim Care Community Health ; 13: 21501319221092244, 2022.
Article in English | MEDLINE | ID: covidwho-1794054
ABSTRACT

INTRODUCTION:

Disparities in COVID-19 infection, illness severity, hospitalization, and death are often attributed to age and comorbidities, which fails to recognize the contribution of social, environmental, and financial factors on health. The purpose of this study was to examine relationships between social determinants of health (SDOH) and COVID-19 severity.

METHODS:

This multicenter retrospective study included adult patients hospitalized with COVID-19 in Southwest Georgia, U.S. The primary outcome was the severity of illness among patients on hospital admission for COVID-19. To characterize the effect of biological and genetic factors combined with SDOH on COVID-19, we used a multilevel analysis to examine patient-level and ZIP code-level data to determine the risk of COVID-19 illness severity at admission.

RESULTS:

Of 392 patients included, 65% presented with moderate or severe COVID-19 compared to 35% with critical disease. Compared to moderate or severe COVID-19, increasing levels of Charlson Comorbidity Index (OR 1.15, 95% CI 1.07-1.24), tobacco use (OR 1.85, 95% CI 1.10-3.11), and unemployment or retired versus employed (OR 1.91, 95% CI 1.04-3.50 and OR 2.17, 95% CI 1.17-4.02, respectively) were associated with increased odds of critical COVID-19 in bivariate models. In the multi-level model, ZIP codes with a higher percentage of Black or African American residents (OR 0.94, 95% CI 0.91-0.97) were associated with decreased odds of critical COVID-19.

CONCLUSION:

Differences in SDOH did not lead to significantly higher odds of presenting with severe COVID-19 when accounting for patient-level and ZIP code-level variables.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Humans Language: English Journal: J Prim Care Community Health Year: 2022 Document Type: Article Affiliation country: 21501319221092244

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Humans Language: English Journal: J Prim Care Community Health Year: 2022 Document Type: Article Affiliation country: 21501319221092244