1. Factors associated with hospital admission and adverse outcome for COVID-19: Role of social factors and medical care
- Author
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Beaumont, Anne Lise, Vignes, Dorothée, Sterpu, Raluca, Bussone, Guillaume, Kansau, Imad, Pignon, Carole, Ben Ismail, R., Favier, Marion, Molitor, J. L., Braham, D., Fior, Renato, Roy, Sandrine, Mion, M., Meyer, Laurence, Andronikof, Marc, Damoisel, Charles, Chagué, Pierre, Aurégan, J. C., Bourgeois-Nicolaos, Nadège, Guillet-Caruba, Christelle, Téglas, Jean Paul, Abgrall, Sophie, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Ligue Contre le Cancer, We would like to acknowledge all patients included in this research. We gratefully thank Dr. Rey Grégoire for sharing the FDEP score with us and for his advice. We would also like to thank the Ligue Nationale Contre le Cancer for sharing the French EDI score via the MapInMed platform (https://www.canceropole-nordouest.org/plateforme-mapinmed/) and Ludivine Launay for her help and availability., and HAL UVSQ, Équipe
- Subjects
[SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,Male ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,Hydrocortisone ,SARS-CoV-2 ,COVID-19 ,Overweight ,Hospitals ,Socioeconomic deprivation ,Hospitalization ,Infectious Diseases ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Geographical origin ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Corticosteroids ,Humans ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Female ,Obesity ,Social Factors - Abstract
International audience; Background: Beyond sex, age, and various comorbidities, geographical origin and socioeconomic deprivation are associated with Coronavirus Disease (COVID-19) morbidity and mortality in the general population. We aimed to assess factors associated with severe forms of COVID-19 after a hospital emergency department visit, focusing on socioeconomic factors. Methods: Patients with laboratory-confirmed COVID-19 attending the emergency department of Béclère Hospital (France) in March–April 2020 were included. Postal addresses were used to obtain two geographical deprivation indices at the neighborhood level. Factors associated with hospitalization and factors associated with adverse outcomes, i.e. mechanical ventilation or death, were studied using logistic and Cox analyses, respectively. Results: Among 399 included patients, 321 were hospitalized. Neither geographical origin nor socioeconomic deprivation was associated with any of the outcomes. Being male, older, overweight or obese, diabetic, or having a neuropsychiatric disorder were independent risk factors for hospitalization. Among 296 patients hospitalized at Béclère Hospital, 91 experienced an adverse outcome. Older age, being overweight or obese, desaturation and extent of chest CT scan lesions > 25% at admission (aHR: 2.2 [95% CI: 1.3–3.5]) and higher peak CRP levels and acute kidney failure (aHR: 2.0 [1.2–3.3]) during follow-up were independently associated with adverse outcomes, whereas treatment with hydrocortisone reduced the risk of mechanical ventilation or death by half (aHR: 0.5 [0.3–0.8]). Conclusion: No association between geographical origin or socioeconomic deprivation and the occurrence of a severe form of COVID-19 was observed in our population after arrival to the emergency department. Empirical corticosteroid use with hydrocortisone had a strong protective impact.
- Published
- 2022