COVID-19 incidence and outcome by affluence/deprivation across three pandemic waves in Ireland: A retrospective cohort study using routinely collected data.

Autor: McKeown D; National Health Intelligence Unit, Health Service Executive, Dublin, Ireland., McCourt A; National Health Intelligence Unit, Health Service Executive, Dublin, Ireland., Hendrick L; National Health Intelligence Unit, Health Service Executive, Dublin, Ireland., O'Farrell A; National Health Intelligence Unit, Health Service Executive, Dublin, Ireland., Donohue F; National Health Intelligence Unit, Health Service Executive, Dublin, Ireland., Grabowsky L; National Health Intelligence Unit, Health Service Executive, Dublin, Ireland., Kavanagh P; National Health Intelligence Unit, Health Service Executive, Dublin, Ireland., Garvey P; Health Protection Surveillance Centre, Health Service Executive, Dublin, Ireland., O'Donnell J; Health Protection Surveillance Centre, Health Service Executive, Dublin, Ireland., O'Connor L; Health Protection Surveillance Centre, Health Service Executive, Dublin, Ireland., Cuddihy J; Health Protection Surveillance Centre, Health Service Executive, Dublin, Ireland., Robinson M; National Health Intelligence Unit, Health Service Executive, Dublin, Ireland., O'Reilly D; National Health Intelligence Unit, Health Service Executive, Dublin, Ireland., Staines A; School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland., Johnson H; National Health Intelligence Unit, Health Service Executive, Dublin, Ireland.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Jul 21; Vol. 18 (7), pp. e0287636. Date of Electronic Publication: 2023 Jul 21 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0287636
Abstrakt: Background: Since the pandemic onset, deprivation has been seen as a significant determinant of COVID-19 incidence and mortality. This study explores outcomes of COVID-19 in the context of material deprivation across three pandemic waves in Ireland.
Methods: Between 1st March 2020 and 13th May 2021, 252,637 PCR-confirmed COVID-19 cases were notified in Ireland. Cases were notified to the national Computerised Infectious Disease Reporting (CIDR) system. Each case was geo-referenced and assigned a deprivation category according to the Haase-Pratschke (HP) Deprivation Index. Regression modelling examined three outcomes: admission to hospital; admission to an intensive care unit (ICU) and death.
Results: Deprivation increased the likelihood of contracting COVID-19 in all age groups and across all pandemic waves, except for the 20-39 age group. Deprivation, age, comorbidity and male gender carried increased risk of hospital admission. Deprivation was not a factor in predicting ICU admission or death, and diagnosis in wave 2 was associated with the lowest risk of all three outcomes.
Conclusions: Our study suggests that COVID-19 spreads easily through all strata of society and particularly in the more deprived population; however this was not a consistent finding. Ireland is ethnically more homogenous than other countries reporting a larger deprivation gradient, and in such societies, structural racial differences may contribute more to poor COVID outcomes than elements of deprivation.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 McKeown et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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