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EVALUATING THE EFFECTS OF SOCIAL DETERMINANTS OF HEALTH ON COVID-19 SEVERITY AT DIAGNOSIS, AND ANXIETY, DEPRESSION AND QUALITY OF LIFE OUTCOMES ≥ 6 MONTHS AFTER DIAGNOSIS
Journal of General Internal Medicine ; 37:S269, 2022.
Article in English | EMBASE | ID: covidwho-1995864
ABSTRACT

BACKGROUND:

COVID-19 continues to be an ongoing problem worldwide, especially for those who are disproportionately affected due to their social determinants of health, as they are often at a socioeconomic disadvantage. We are primarily interested in evaluating how education level, income, race, ethnicity, and obesity are correlated with acute COVID-19 severity, and anxiety, depression, and quality of life ≥ 6 months post-infection. Specifically, obesity (BMI > 30), has been previously identified as a risk factor for COVID- 19 regarding severity and mortality. We found it imperative to further investigate these demographic variables, as they are vital in understanding how social determinants of health are impacting COVID-19 outcomes. Insights from this study can assist with identifying gaps in care for those with poor social determinants of health, as well as help shape care for those who have been disproportionately affected.

METHODS:

We examined records of COVID-19 patients through the COVID-19 Recovery Clinic at George Washington University in Washington, D.C. that has been collecting data on patient short and long-term COVID-19 outcomes in various domains along with demographic information since November 2020. Using RStudio with calculations of descriptive data, odds ratios, and p-values using Fisher's exact test, we assessed education level, income, race, ethnicity, and obesity and looked at how they correlated with COVID-19 severity at diagnosis, presence of anxiety, depression and quality of life ≥ 6 months after acute infection.

RESULTS:

From our sample (n=150), we found African Americans had greater acute COVID-19 severity (OR=7.56, 95% CI 2.22, 25.68, p=0.0015) relative to white individuals. We also found that obesity was associated with higher levels of acute COVID-19 severity (OR=4.89, 95% CI 1.36, 17.60, p=0.022).Additionally, during acute COVID-19 infection, 7/32 (21.9%) obese patients compared to 9/112 (8.0%) non-obese patients were hospitalized (OR=3.79, 95%CI=1.23, 11.68, p=0.03).No significant association was found between anxiety, depression, quality of life or COVID- 19 severity and persistent symptoms.

CONCLUSIONS:

We observed associations between the African American race and more severe acute COVID-19 infection. Further, in the acute phase, we observed that obese patients were more likely than non-obsese patients to have more severe infection and be hospitalized. These findings highlight preexisting gaps in healthcare outcomes regarding social determinants of health. It is essential to analyze many of the potential longer-term effects of COVID-19 infection, as they remain poorly understood. We conclude that larger studies are necessary to better understand the effects of social determinants of health on both short and long-term outcomes of COVID-19.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies / Prognostic study Language: English Journal: Journal of General Internal Medicine Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies / Prognostic study Language: English Journal: Journal of General Internal Medicine Year: 2022 Document Type: Article