Title | Influence of social deprivation index on in-hospital outcomes of COVID-19. |
Publication Type | Journal Article |
Year of Publication | 2023 |
Authors | Goyal P, Schenck E, Wu Y, Zhang Y, Visaria A, Orlander D, Xi W, Díaz I, Morozyuk D, Weiner M, Kaushal R, Banerjee S |
Journal | Sci Rep |
Volume | 13 |
Issue | 1 |
Pagination | 1746 |
Date Published | 2023 Jan 31 |
ISSN | 2045-2322 |
Keywords | Adult, 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. |
DOI | 10.1038/s41598-023-28362-0 |
Alternate Journal | Sci Rep |
PubMed ID | 36720999 |
PubMed Central ID | PMC9887560 |
Grant List | K23 HL151876 / HL / NHLBI NIH HHS / United States P50 MH113838 / MH / NIMH NIH HHS / United States |