Social determinants of health associated with severity and mortality in patients with COVID-19

Ortega-Palavecinos, Maritza; Soto-Carmona, Camilo; Torres-Gangas, Pablo; Concha-Rivero, Ma Paz; Torres‐Castro, Rodrigo

doi:10.24875/gmm.m21000556

Cited by 10 publications

(9 citation statements)

References 33 publications

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“… 42 Although muscle power is considered one of the main therapeutic objectives in older adults, in patients post COVID-19, the assessment of muscle power should be within a comprehensive evaluation that considers loss of independence in activities of daily living, 43 impaired respiratory function, 44 comorbidity burden, 45 and social risk factors. 46 In this context, multidisciplinary health care teams must consider all these aspects when implementing the best strategies to improve the functionality and quality of life of COVID-19 survivors. 47 For example, considering lower extremity strengthening based on 30s-STS power findings.…”

Section: Discussionmentioning

confidence: 99%

30 s sit-to-stand power is positively associated with chest muscle thickness in COVID-19 survivors

et al. 2022

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Introduction After hospitalization, early detection of musculoskeletal sequelae might help healthcare professionals to improve and individualize treatment, accelerating recovery after COVID-19. The objective was to determine the association between the 30s sit-to-stand muscle power (30s-STS) and cross-sectional area of the chest muscles (pectoralis) in COVID-19 survivors. Method This cross-sectional study collected routine data from COVID-19 survivors one month after hospitalization: 1) a chest computed tomography (CT) scan and 2) a functional capacity test (30s-STS). The pectoralis muscle area (PMA) was measured from axial CT images. For each gender, patients were categorized into tertiles based on PMA. The 30s-STS was performed to determine the leg extension power. The allometric and relative STS power were calculated as absolute 30s-STS power normalized to height squared and body mass. The two-way ANOVA was used to compare the gender-stratified tertiles of 30s-STS power variants. Results Fifty-eight COVID-19 survivors were included (mean age 61.2 ± 12.9 years, 30/28 (51.7%/48.3%) men/women). The two-way ANOVA showed significant differences between the PMA tertiles in absolute STS power ( p = .002) and allometric STS power ( p = .001). There were no significant gender x PMA tertile interactions (all variables p > .05). The high tertile of PMA showed a higher allometric STS power compared to the low and middle tertile, p = .002 and p = .004, respectively. Absolute STS power and allometric STS power had a moderate correlation with the PMA, r = 0.519 ( p < .001) and r = 0.458 ( p < .001) respectively. Conclusion The 30s-STS power is associated with pectoralis muscle thickness in both male and female COVID-19 survivors. Thus, this test may indicate global muscle-wasting and may be used as a screening tool for lower extremity functional capacity in the early stages of rehabilitation planning in COVID-19 survivors.

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Section: Discussionmentioning

confidence: 99%

30 s sit-to-stand power is positively associated with chest muscle thickness in COVID-19 survivors

et al. 2022

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“…In addition, the CCI could be added to follow-up programs, as it could help discriminate those patients who could benefit from interventions, such as physical rehabilitation or at least closer follow-up. Multidisciplinary rehabilitation teams should also be aware of the impact of social determinants of health on the severity of COVID-19 to promote strategies that improve the long-term functionality of these patients [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Charlson Comorbidity Index on the Functional Capacity of COVID-19 Survivors: A Prospective Cohort Study with One-Year Follow-Up

Malhue-Vidal¹,

Gath²,

Valdivia-Lobos³

et al. 2022

IJERPH

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Objective: To determine the association between the Charlson comorbidity index (CCI) score after discharge with 6-min walk test (6MWT) 1 year after discharge in a cohort of COVID-19 survivors. Methods: In this prospective study, data were collected from a consecutive sample of patients hospitalized for COVID-19. The CCI score was calculated from the comorbidity data. The main outcome was the distance walked in the 6MWT at 1 year after discharge. Associations between CCI and meters covered in the 6MWT were assessed through crude and adjusted linear regressions. The model was adjusted for possible confounding factors (sex, days of hospitalization, and basal physical capacity through sit-to-stand test one month after discharge). Results: A total of 41 patients were included (mean age 58.8 ± 12.7 years, 20/21 men/women). A significant association was observed between CCI and 6MWT (meters): (i) crude model: β = −18.7, 95% CI = −34.7 to −2.6, p < 0.05; (ii) model adjusted for propensity score including sex, days of hospitalization, and sit-to-stand: β = −23.0, 95% CI = −39.1 to −6.8, p < 0.05. Conclusions: A higher CCI score after discharge indicates worse performance on the 6MWT at 1-year follow-up in COVID-19 survivors. The CCI score could also be used as a screening tool to make important clinical decisions.

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“…Another critical point to consider is the influence of social determinants. Our country is not alien to this reality, and it has already been shown that these social determinants contributed to greater alteration in functioning and higher mortality in the hospitalized population ( 49 , 50 ). One of the ways to reduce this effect is the implementation of these policies at the national level involving public and private health, favoring access to the most vulnerable population.…”

Section: Discussionmentioning

confidence: 99%

How a Developing Country Faces COVID-19 Rehabilitation: The Chilean Experience

Torres‐Castro

Neculhueque-Zapata

Hrzic-Miranda

et al. 2022

Front. Public Health

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The coronavirus 19 (COVID-19) pandemic has been one of the most significant challenges to public health in recent decades. The heterogeneity of government responses and the varying preparedness of health systems has determined that the pandemic's impact differs from country to country. Chile is no stranger to the challenges posed by rehabilitation in a developing country. We aimed to describe the approach to rehabilitation during the pandemic in Chile in the public health system since rehabilitation is considered a relevant health strategy from the prevention to management of complications, mitigation of sequelae, or new complications associated with COVID-19. For this, a descriptive study was conducted on the rehabilitation strategies implemented by Chile to respond to the COVID-19 pandemic. The analysis includes the context of the Chilean health system and the matrix of access to rehabilitation services in COVID-19. The Health Ministry (MINSAL) rehabilitation strategy includes five central axes: approaches, specific lines, transversal lines, intervention, and funding. Additionally, the policies were based and supported by the WHO recommendations. Intensive care unit beds were increased approximately 68%, and the primary care response was the reconversion of function depending on the epidemiological context. During the 2021–2022 period, the estimated number of people diagnosed with a post-COVID-19 condition was 80,528. With this, we can conclude that a developing country has managed to coordinate a rehabilitation policy for people with COVID-19 by generating a structure of the different health system levels. However, the effectiveness of this policy will need to be evaluated in the future.

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Social determinants of health associated with severity and mortality in patients with COVID-19

Cited by 10 publications

References 33 publications

30 s sit-to-stand power is positively associated with chest muscle thickness in COVID-19 survivors

30 s sit-to-stand power is positively associated with chest muscle thickness in COVID-19 survivors

The Impact of Charlson Comorbidity Index on the Functional Capacity of COVID-19 Survivors: A Prospective Cohort Study with One-Year Follow-Up

How a Developing Country Faces COVID-19 Rehabilitation: The Chilean Experience

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