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- Title
Impact of socioeconomic status on the clinical outcomes in hospitalised patients with SARS-CoV-2 infection: a retrospective analysis.
- Authors
Boglione, Lucio; Dodaro, Valentina
- Abstract
Aim: A disadvantaged socioeconomic status (SES) was previously associated with higher incidence and poor outcomes both of non-communicable diseases (NCDs) and infectious diseases. Inequalities in health services also have a negative effect on the coronavirus disease 2019 (COVID-19) morbidity and mortality. Subject and methods: The study analysed the role of SES measured by the educational level (EL) in hospitalised patients with COVID-19 between 9 March 2020 and 20 September 2021 at our centre of infectious diseases. Clinical outcomes were: length of hospitalisation, in-hospital mortality and the need of intensive-care-unit (ICU) support. Results: There were 566 patients included in this retrospective analysis. Baseline EL was: illiterate (5, 0.9%), primary school (99, 17.5%), secondary school (228, 40.3%), high school (211, 37.3%), degree (23, 4.1%); median age was higher in low EL (72.5 years vs 61 years, p = 0.003), comorbidity (56% in low EL, 34.6% in high EL, p < 0.001), time from the symptoms and PCR diagnosis (8.5 days in low EL, 6.5 days in high EL, p < 0.001), hospitalisation length (11.5 days in low EL, 9.5 days in high EL, p = 0.011), mortality rate (24.7% in low EL, 13.2% in high EL, p < 0.001). In the multivariate analysis there were predictors of mortality: age (OR = 4.981; 95%CI 2.172–11.427; p < 0.001), comorbidities (OR = 3.227; 95%CI 2.515–11.919; p = 0.007), ICU admission (OR = 6.997; 95%CI 2.334–31.404; p = 0.011), high vs low EL (OR = 0.761; 95%CI 0.213–0.990; p = 0.021). In survival analysis, higher EL was associated with a decreased risk of mortality up to 23.9%. Conclusion: Even though the EL is mainly related to the age of patients, in our analysis, it resulted as an independent predictor of in-hospital mortality and hospitalisation time. Unfortunately, this is a study focused only on hospitalised patients, and we did not examine the possible effect of EL in outpatients. Further analyses are required to confirm this suggestion and provide novel information.
- Subjects
ITALY; COMMUNICABLE disease epidemiology; EVALUATION of medical care; NON-communicable diseases; LENGTH of stay in hospitals; INTENSIVE care units; REVERSE transcriptase polymerase chain reaction; STATISTICS; HOSPITAL patients; COVID-19; CONFIDENCE intervals; MULTIVARIATE analysis; MULTIPLE regression analysis; LOG-rank test; DISEASES; RETROSPECTIVE studies; HOSPITAL mortality; SOCIAL classes; DESCRIPTIVE statistics; CHI-squared test; KAPLAN-Meier estimator; SURVIVAL analysis (Biometry); RESEARCH funding; HEALTH equity; ODDS ratio; DATA analysis; DATA analysis software; COMORBIDITY
- Publication
Journal of Public Health (09431853), 2023, Vol 31, Issue 10, p1691
- ISSN
0943-1853
- Publication type
Article
- DOI
10.1007/s10389-022-01730-2