Socioeconomic deprivation and illness trajectory in the Scottish population after COVID-19 hospitalization.
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Morrow Andrew J, Sykes Robert, Saleh Merna, Zahra Baryab, MacIntosh Alasdair, Kamdar Anna, Bagot Catherine, Bayes Hannah K, Blyth Kevin G, Bulluck Heerajnarain, Carrick David, Church Colin, Corcoran David, Findlay Iain, Gibson Vivienne B, Gillespie Lynsey, Grieve Douglas, Barrientos Pauline Hall, Ho Antonia, Lang Ninian N, Lowe David J, Lennie Vera, Macfarlane Peter W, Mayne Kaitlin J, Mark Patrick B, McConnachie Alex, McGeoch Ross, Nordin Sabrina, Payne Alexander, Rankin Alastair J, Robertson Keith, Ryan Nicola, Roditi Giles, Sattar Naveed, Stobo David, Allwood-Spiers Sarah, Touyz Rhian M, Veldtman Gruschen, Weeden Sarah, Weir Robin, Watkins Stuart, Welsh Paul, Mangion Kenneth, Berry Colin
Аннотация
METHODS: A prospective, multicentre cohort study was conducted on post-COVID-19 patients, enrolled either in-hospital or shortly post-discharge. Two evaluations were carried out: an initial assessment and a follow-up at 28-60 days post-discharge. The study encompassed research blood tests, patient-reported outcome measures, and multisystem imaging (including chest computed tomography (CT) with pulmonary and coronary angiography, cardiovascular and renal magnetic resonance imaging). Primary and secondary outcomes were analysed in relation to socioeconomic status, using the Scottish Index of Multiple Deprivation (SIMD). The EQ-5D-5L, Brief Illness Perception Questionnaire (BIPQ), Patient Health Questionnaire-4 (PHQ-4) for Anxiety and Depression, and the Duke Activity Status Index (DASI) were used to assess health status.
RESULTS: Of the 252 enrolled patients (mean age 55.0 ± 12.0 years; 40% female; 23% with diabetes), deprivation status was linked with increased BMI and diabetes prevalence. 186 (74%) returned for the follow-up. Within this group, findings indicated associations between deprivation and lung abnormalities (p = 0.0085), coronary artery disease (p = 0.0128), and renal inflammation (p = 0.0421). Furthermore, patients with higher deprivation exhibited worse scores in health-related quality of life (EQ-5D-5L, p = 0.0084), illness perception (BIPQ, p = 0.0004), anxiety and depression levels (PHQ-4, p = 0.0038), and diminished physical activity (DASI, p = 0.002). At the 3-month mark, those with greater deprivation showed a higher frequency of referrals to secondary care due to ongoing COVID-19 symptoms (p = 0.0438). However, clinical outcomes were not influenced by deprivation.
CONCLUSIONS: In a post-hospital COVID-19 population, socioeconomic deprivation was associated with impaired health status and secondary care episodes. Deprivation influences illness trajectory after COVID-19.