Impact of Social Deprivation on Hospitalization and Intensive Care Unit Admission among COVID-19 Patients: A Systematic Review and Meta-Analysis

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected socially disadvantaged groups;however, the association between socioeconomic status and healthcare utilization among COVID-19 patients remains unclear. Therefore, a systematic review and meta-analysis was conducted to assess the association between socioeconomic status and hospitalization and intensive care unit admission among COVID-19 patients.Methods: PubMed, Embase, and the Cochrane Register of Controlled Trials were searched for relevant litera-ture (updated to Jun 2022). Studies that investigated the association of social deprivation with hospitalization and intensive care unit admission in COVID-19 patients were included. The primary outcomes included risk of hospitalization and intensive care unit admission, measured by odds ratio.Results: Eleven studies covering 2,423,095 patients were included in the meta-analysis. Socially disadvantaged patients had higher odds of hospitalization in comparison to socially advantaged patients (odds ratio 1.25, 95% confidence interval 1.14 to 1.38;P<0.01). The odds of intensive care unit admission among more deprived patients was not significantly different from that of less deprived patients (odds ratio 1.03, 95% confidence interval 0.78 to 1.35;P=0.85). These findings were proven robust through subgroup and sensitivity analyses.Conclusion: Socially disadvantaged populations have higher odds of hospitalization if they become infected with COVID-19. More effective medical support and interventions for these vulnerable populations are re-quired to reduce inequity in healthcare utilization and alleviate the burden on healthcare systems.