Social Determinants of Health and COVID-19 Among Patients in New York City

Baidal, Jennifer Woo; Wang, Amanda Y; Zumwalt, Katarina; Gary, Dahsan; Greenberg, Yael V.; Cormack, Ben; Lovinsky‐Desir, Stephanie; Nichols, Kelsey; Pasco, Neil; Nieto, Andres; Ancker, Jessica S.; Goldsmith, Jeff; Meyer, Dodi

doi:10.21203/rs.3.rs-70959/v1

Cited by 14 publications

(22 citation statements)

References 3 publications

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“…However, Hispanic patients were underrepresented in the Optum population relative to the census population (Table 1). Our findings related to minority populations and sub-optimal health insurance are consistent with prior research demonstrating the importance of societal and economic inequities, differential exposure, access to tests over the course of the pandemic [12, 13, 16, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29].…”

Section: Discussionsupporting

confidence: 90%

Viral And Antibody Testing For Coronavirus Disease 2019 (Covid-19): Factors Associated With Positivity In Electronic Health Records From The United States

Lindsay¹,

Mh²,

Rizzo³

et al. 2021

Preprint

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Background. Insufficient information on SARS-CoV-2 testing results exists in clinical practice from the United States. Methods. We conducted an observational retrospective cohort study using Optum® de-identified COVID-19 electronic health records from the United States to characterize patients who received a SARS-CoV-2 viral or antibody test between February 20, 2020 and July 10, 2020. We assessed temporal trends in testing and positivity by demographic and clinical characteristics; evaluated concordance between viral and antibody tests; and identified factors associated with positivity via multivariable logistic regression. Results. Our study population included 891,754 patients. Overall positivity rate for SARS-CoV-2 was 9% and 12% for viral and antibody tests, respectively. Positivity rate was inversely associated with the number of individuals tested and decreased over time across regions and race/ethnicities. Among patients who received a viral test followed by an antibody test, concordance ranged from 90%-93% depending on the duration between the two tests which is notable given uncertainties related to specific viral and antibody test characteristics. The following factors increased the odds of viral and antibody positivity in multivariable models: male, Hispanic or non-Hispanic Black and Asian, uninsured or Medicaid insurance, Northeast residence, dementia, diabetes, and obesity. Charlson Comorbidity Index was negatively associated with test positivity. We identified symptoms that were positively associated with test positivity, as well as, commonly co-occurring symptoms / conditions. Pediatric patients had reduced odds of a positive viral test, but conversely had increased odds of a positive antibody test. Conclusions. This study identified sociodemographic and clinical factors associated with SARS-CoV-2 testing and positivity within routine clinical practice from the United States.

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Section: Discussionsupporting

confidence: 90%

Viral And Antibody Testing For Coronavirus Disease 2019 (Covid-19): Factors Associated With Positivity In Electronic Health Records From The United States

Lindsay¹,

Mh²,

Rizzo³

et al. 2021

Preprint

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“…Only 40 papers included the number of events for both hospitalised patients and outpatients. The 40 papers 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 underwent the quality assessment and were included in our meta‐analysis (Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…The systematic review identified a total of 1,002,006 patients (188,597 hospitalised patients and 813,409 outpatients). The studies included 26 cohort studies, 26 , 27 , 28 , 29 , 30 , 32 , 34 , 35 , 36 , 37 , 42 , 44 , 45 , 46 , 48 , 49 , 51 , 52 , 53 , 54 , 55 , 56 , 60 , 62 , 63 , 64 7 cross‐sectional studies, 33 , 38 , 39 , 41 , 47 , 50 , 61 and 7 reports and case series 25 , 31 , 40 , 43 , 57 , 58 , 59 that were developed between December 2019 and December 2020. The included studies were conducted in the United States (27 studies), 25 , 26 , 28 , 30 , 31 , 32 , 33 , 35 , 36 , 38 , …”

Section: Resultsmentioning

confidence: 99%

“…The included studies were conducted in the United States (27 studies), 25 , 26 , 28 , 30 , 31 , 32 , 33 , 35 , 36 , 38 , 40 , 42 , 43 , 44 , 45 , 46 , 48 , 49 , 52 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 62 Mexico, 39 , 51 United Kingdom, 37 , 63 Spain 29 , 41 (2 studies conducted in each country), Brazil, 47 Chile, 61 Denmark, 53 France, 50 Honduras, 64 Italy, 34 and Turkey, 27 (1 study conducted in each country). A total of 4 pre‐print articles 28 , 37 , 46 , 54 were included in the meta‐analysis (Table 1 ). Age was not assessed in our analysis, due to high variation in the descriptive statistics on age.…”

Section: Resultsmentioning

confidence: 99%

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Hospitalised versus outpatient COVID‐19 patients' background characteristics and comorbidities: A systematic review and meta‐analysis

Mattey-Mora

Begle

Owusu

et al. 2021

Reviews in Medical Virology

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This study aimed to systematically assess COVID‐19 patient background characteristics and pre‐existing comorbidities associated with hospitalisation status. The meta‐analysis included cross‐sectional, cohort, and case‐series studies with information on hospitalisation versus outpatient status for COVID‐19 patients, with background characteristics and pre‐existing comorbidities. A total of 1,002,006 patients from 40 studies were identified. Significantly higher odds of hospitalisation were observed in Black individuals (OR = 1.33, 95% CI: 1.04–1.70), males (OR = 1.59, 95% CI: 1.43–1.76), and persons with current/past smoking (OR = 1.59, 95% CI: 1.34–1.88). Additionally, individuals with pre‐existing comorbidities were more likely to be hospitalised [asthma (OR = 1.22, 95% CI: 1.02–1.45), COPD (OR = 3.68, 95% CI: 2.97–4.55), congestive heart failure (OR = 6.80, 95% CI: 4.97–9.31), coronary heart disease (OR = 4.40, 95% CI: 3.15–6.16), diabetes (OR = 3.90, 95% CI: 3.29–4.63), hypertension (OR = 3.89, 95% CI: 3.34–4.54), obesity (OR = 1.98, 95% CI: 1.59–2.46) and renal chronic disease (OR = 5.84, 95% CI: 4.51–7.56)]. High heterogeneity and low publication bias among all factors were found. Age was not included due to the large variability in the estimates reported. In this systematic review/meta‐analysis for patients with COVID‐19, Black patients, males, persons who smoke, and those with pre‐existing comorbidities were more likely to be hospitalised than their counterparts. Findings provide evidence of populations with higher odds of hospitalisation for COVID‐19.

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“…In the literature, it has been found that communities with higher poverty, lower-income, and lower social security coverage have shown a higher prevalence of COVID-19. 29 Environmental factors such as living in a neighbourhood with poor air quality, insecurity related to housing, insecurity related to transportation, 30 household size, low educational level, [31] , [32] and public social security 33 have also been associated with a higher probability of having COVID-19 at the community level. These results are consistent with our findings, where a larger household size was also positively associated with a higher risk of SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With SARS-CoV-2 Infection in Bogotá, Colombia: Results From a Large Epidemiological Surveillance Study

Varela

Flórez

Tamayo-Cabeza

et al. 2021

The Lancet Regional Health - Americas

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Background Epidemiologic surveillance of COVID-19 is essential to collect and analyse data to improve public health decision making during the pandemic. There are few initiatives led by public-private alliances in Colombia and Latin America. The CoVIDA project contributed with RT-PCR tests for SARS-CoV-2 in mild or asymptomatic populations in Bogotá. The present study aimed to determine the factors associated with SARS-CoV-2 infection in working adults. Methods COVID-19 intensified sentinel epidemiological surveillance study, from April 18, 2020, to March 29, 2021. The study included people aged 18 years or older without a history of COVID-19. Two main occupational groups were included: healthcare and essential services workers with high mobility in the city. Social, demographic, and health-related factors were collected via phone survey. Afterwards, the molecular test was conducted to detect SARS-CoV-2 infection. Findings From the 58,638 participants included in the study, 3,310 (5·6%) had a positive result. A positive result was associated with the age group (18-29 years) compared with participants aged 60 or older, participants living with more than three cohabitants, living with a confirmed case, having no affiliation to the health system compared to those with social health security, reporting a very low socioeconomic status compared to those with higher socioeconomic status, and having essential occupations compared to healthcare workers. Interpretation The CoVIDA study showed the importance of intensified epidemiological surveillance to identify groups with increased risk of infection. These groups should be prioritised in the screening, contact tracing, and vaccination strategies to mitigate the pandemic.

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Social Determinants of Health and COVID-19 Among Patients in New York City

Cited by 14 publications

References 3 publications

Viral And Antibody Testing For Coronavirus Disease 2019 (Covid-19): Factors Associated With Positivity In Electronic Health Records From The United States

Viral And Antibody Testing For Coronavirus Disease 2019 (Covid-19): Factors Associated With Positivity In Electronic Health Records From The United States

Hospitalised versus outpatient COVID‐19 patients' background characteristics and comorbidities: A systematic review and meta‐analysis

Factors Associated With SARS-CoV-2 Infection in Bogotá, Colombia: Results From a Large Epidemiological Surveillance Study

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