Impact of socioeconomic status on the clinical outcomes in hospitalised patients with SARS-CoV-2 infection: a retrospective analysis

Lucio Boglione, Valentina Dodaro

Risultato della ricerca: Contributo su rivistaArticolo in rivistapeer review

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.

Lingua originaleInglese
pagine (da-a)1691-1697
Numero di pagine7
RivistaZeitschrift fur Gesundheitswissenschaften
Volume31
Numero di pubblicazione10
DOI
Stato di pubblicazionePubblicato - ott 2023

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