Influence of social deprivation index on in-hospital outcomes of COVID-19.

TitleInfluence of social deprivation index on in-hospital outcomes of COVID-19.
Publication TypeJournal Article
Year of Publication2023
AuthorsGoyal P, Schenck E, Wu Y, Zhang Y, Visaria A, Orlander D, Xi W, Díaz I, Morozyuk D, Weiner M, Kaushal R, Banerjee S
JournalSci Rep
Volume13
Issue1
Pagination1746
Date Published2023 Jan 31
ISSN2045-2322
KeywordsAdult, Area Under Curve, COVID-19, Health Status, Health Status Disparities, Hospitals, Humans, Social Deprivation
Abstract

While it is known that social deprivation index (SDI) plays an important role on risk for acquiring Coronavirus Disease 2019 (COVID-19), the impact of SDI on in-hospital outcomes such as intubation and mortality are less well-characterized. We analyzed electronic health record data of adults hospitalized with confirmed COVID-19 between March 1, 2020 and February 8, 2021 from the INSIGHT Clinical Research Network (CRN). To compute the SDI (exposure variable), we linked clinical data using patient's residential zip-code with social data at zip-code tabulation area. SDI is a composite of seven socioeconomic characteristics determinants at the zip-code level. For this analysis, we categorized SDI into quintiles. The two outcomes of interest were in-hospital intubation and mortality. For each outcome, we examined logistic regression and random forests to determine incremental value of SDI in predicting outcomes. We studied 30,016 included COVID-19 patients. In a logistic regression model for intubation, a model including demographics, comorbidity, and vitals had an Area under the receiver operating characteristic curve (AUROC) = 0.73 (95% CI 0.70-0.75); the addition of SDI did not improve prediction [AUROC = 0.73 (95% CI 0.71-0.75)]. In a logistic regression model for in-hospital mortality, demographics, comorbidity, and vitals had an AUROC = 0.80 (95% CI 0.79-0.82); the addition of SDI in Model 2 did not improve prediction [AUROC = 0.81 (95% CI 0.79-0.82)]. Random forests revealed similar findings. SDI did not provide incremental improvement in predicting in-hospital intubation or mortality. SDI plays an important role on who acquires COVID-19 and its severity; but once hospitalized, SDI appears less important.

DOI10.1038/s41598-023-28362-0
Alternate JournalSci Rep
PubMed ID36720999
PubMed Central IDPMC9887560
Grant ListK23 HL151876 / HL / NHLBI NIH HHS / United States
P50 MH113838 / MH / NIMH NIH HHS / United States