Associations between cardiometabolic disease severity, social determinants of health (SDoH), and poor COVID‐19 outcomes

Howell, Carrie R.; Zhang, Li; Yi, Nengjun; Mehta, Tapan; Cherrington, Andrea; Garvey, W. Timothy

doi:10.1002/oby.23440

Cited by 11 publications

(4 citation statements)

References 50 publications

(60 reference statements)

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“…It is well known that sustained, chronic stress has several deleterious effects on normal physiology. It sets off a chain reaction within the body, sparking inflammatory responses and prompting intricate alterations in gene expression, known as epigenetic modifications 44 . These modifications, in turn, have the potential to significantly impact health outcomes, potentially worsening the long-term effects of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Patients with unmet social needs are at higher risks of developing severe long COVID-19 symptoms and neuropsychiatric sequela

Eligulashvili,

Darrell,

Gordon

et al. 2024

Sci Rep

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This study investigated long COVID of patients in the Montefiore Health System COVID-19 (CORE) Clinics in the Bronx with an emphasis on identifying health related social needs (HRSNs). We analyzed a cohort of 643 CORE patients (6/26/2020–2/24/2023) and 52,089 non-CORE COVID-19 patients. Outcomes included symptoms, physical, emotional, and cognitive function test scores obtained at least three months post-infection. Socioeconomic variables included median incomes, insurance status, and HRSNs. The CORE cohort was older age (53.38 ± 14.50 vs. 45.91 ± 23.79 years old, p < 0.001), more female (72.47% vs. 56.86%, p < 0.001), had higher prevalence of hypertension (45.88% vs. 23.28%, p < 0.001), diabetes (22.86% vs. 13.83%, p < 0.001), COPD (7.15% vs. 2.28%, p < 0.001), asthma (25.51% vs. 12.66%, p < 0.001), lower incomes (53.81% vs. 43.67%, 1st quintile, p < 0.001), and more unmet social needs (29.81% vs. 18.49%, p < 0.001) compared to non-CORE COVID-19 survivors. CORE patients reported a wide range of severe long-COVID symptoms. CORE patients with unmet HRSNs experienced more severe symptoms, worse ESAS-r scores (tiredness, wellbeing, shortness of breath, and pain), PHQ-9 scores (12.5 (6, 17.75) vs. 7 (2, 12), p < 0.001), and GAD-7 scores (8.5 (3, 15) vs. 4 (0, 9), p < 0.001) compared to CORE patients without. Patients with unmet HRSNs experienced worse long-COVID outcomes compared to those without.

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Section: Discussionmentioning

confidence: 99%

Patients with unmet social needs are at higher risks of developing severe long COVID-19 symptoms and neuropsychiatric sequela

Eligulashvili,

Darrell,

Gordon

et al. 2024

Sci Rep

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show abstract

“…This nding is consistent with the results of the present study. BMI is associated with unfavorable SDoH in developed countries [36,37] . However, the Chinese Longitudinal Healthy Longevity Survey showed that patients with low BMI had more unfavorable SDoH [38] , which is consistent with the results of our study.…”

Section: Discussionmentioning

confidence: 99%

Causal Association of Social Determinants of Health and Dynamic Impact on Mortality in Patients with Chronic Heart Failure

Wang,

Song,

et al. 2024

Preprint

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Purpose The causality between social determinants of health (SDoH) and mortality in patients with chronic heart failure (CHF) is uncertain. Herein, we assessed the causality using inverse probability weighting (IPW) of marginal structural models (MSMs) during the course of CHF. Method A multicenter, prospective cohort study of 1377 patients with CHF were enrolled from September 2017. The social domain and two dimensions of Chronic Heart Failure Patient-Reported Outcomes Measure (CHF-PROM) was used to assess the SDoH, social support, and support utilization of patients with CHF. CHF-PROM and mortality information were obtained at 1, 3, and 6 months following patient discharge, and every 6 months thereafter at regular follow-ups. Logistic regression and IPW of MSMs were applied to analyze the SDoH, social support, and support utilization on mortality in patients with CHF. Results Logistic regression showed that at baseline, the SDoH, social support, and support utilization were not associated with mortality in patients with CHF. After adjusting for confounders, MSMs showed that the SDoH and social support were not associated with mortality at baseline. In contrast, low support utilization at baseline and unfavorable SDoH, low social support, and low support utilization during follow-up increased the risk of death in patients with CHF. Conclusion Through follow-up data and MSMs analysis, we found that the long-term out-of-hospital causal effects, but not one-time effects of SDoH, are risk factors for CHF mortality. SDoH should be taken seriously during the entire CHF process to prolong patients’ survival. Trial registration: The cohort number registered in the China Clinical Trial Registry is ChiCTR2100043337. URL: https://www.chictr.org.cn/showproj.html?proj=64980 Registered on February 11, 2021

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“…It is well known that sustained, chronic stress has several deleterious effects on normal physiology. It sets off a chain reaction within the body, sparking in ammatory responses and prompting intricate alterations in gene expression, known as epigenetic modi cations 40 . These modi cations, in turn, have the potential to signi cantly impact health outcomes, potentially worsening the long-term effects of COVID-19.…”

Section: Disease Severitymentioning

confidence: 99%

Patients with unmet social needs are at higher risks of developing severe long COVID-19 symptoms and neuropsychiatric sequela

Eligulashvili,

Darrell,

Gordon

et al. 2023

Preprint

View full text Add to dashboard Cite

This study investigated long COVID of patients in the Montefiore Health System COVID-19 (CORE) Clinics in the Bronx with an emphasis on identifying health related social needs (HRSNs). We analyzed a cohort of 643 CORE patients (6/26/2020-2/24/2023) and 52,089 non-CORE COVID-19 patients. Outcomes included symptoms, physical, emotional, and cognitive function test scores obtained at least three months post-infection. Socioeconomic variables included median incomes, insurance status, and HRSNs. The CORE cohort was older age (53.38 ± 14.50 versus 45.91 ± 23.79 years old, p < 0.001), more female (72.47% vs 56.86%, p < 0.001), had higher prevalence of hypertension (45.88% vs 23.28%, p < 0.001), diabetes (22.86% vs 13.83%, p < 0.001), COPD (7.15% vs 2.28%, p < 0.001), asthma (25.51% vs 12.66%, p < 0.001), lower incomes (53.81% vs 43.67%, 1st quintile, p < 0.001), and more unmet social needs (29.81% vs 18.49%, p < 0.001) compared to non-CORE COVID-19 survivors. CORE patients reported a wide range of severe long-COVID symptoms. CORE patients with unmet HRSNs experienced more severe symptoms, worse ESAS-r scores (wellbeing, shortness of breath, anxiety, and depression), PHQ-9 scores (overall: 12.05 ± 7.07 vs 7.71 ± 6.35, p < 0.001), and GAD-7 scores (overall: 9.26 ± 6.63 vs 5.28 ± 5.72, p < 0.001) compared to CORE patients without. Patients with unmet HRSNs experienced worse long-COVID outcomes compared to those without.

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Associations between cardiometabolic disease severity, social determinants of health (SDoH), and poor COVID‐19 outcomes

Cited by 11 publications

References 50 publications

Patients with unmet social needs are at higher risks of developing severe long COVID-19 symptoms and neuropsychiatric sequela

Patients with unmet social needs are at higher risks of developing severe long COVID-19 symptoms and neuropsychiatric sequela

Causal Association of Social Determinants of Health and Dynamic Impact on Mortality in Patients with Chronic Heart Failure

Patients with unmet social needs are at higher risks of developing severe long COVID-19 symptoms and neuropsychiatric sequela

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