Socioeconomic deprivation and illness trajectory in the Scottish population after COVID-19 hospitalization

Morrow, A. J. et al. (2024) Socioeconomic deprivation and illness trajectory in the Scottish population after COVID-19 hospitalization. Communications Medicine, 4, 32. (doi: 10.1038/s43856-024-00455-5) (PMID:38418616) (PMCID:PMC10901805)

Abstract

Background The associations between deprivation and illness trajectory after hospitalisation for coronavirus disease-19 (COVID-19) are uncertain. 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.

• Item Type: Articles
• Additional Information: CISCO-19 was an investigator-initiated clinical study that was funded by the Chief Scientist Office of the Scottish Government (COV/GLA/Portfolio project number 311300). C.B, C.D., N.S., R.M.T. were supported by the British Heart Foundation (RE/18/6134217).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Macfarlane, Professor Peter and Veldtman, Professor Gruschen and Robertson, Dr Keith and Carrick, Dr David and Church, Dr Colin and Bulluck, Dr Heerajnarain and Corcoran, Dr David and Gibson, Dr Vivienne and Mangion, Dr Kenneth and Morrow, Dr Andrew and Nordin, Dr Sabrina and Blyth, Professor Kevin and Roditi, Dr Giles and Weeden, Dr Sarah and Sykes, Dr Robert and Bayes, Dr Hannah and Kamdar, Anna and McConnachie, Professor Alex and Mark, Professor Patrick and Welsh, Professor Paul and Gillespie, Dr Lynsey and Ho, Dr Antonia and Rankin, Dr Alastair and Watkins, Dr Stuart and Bagot, Dr Catherine and Touyz, Professor Rhian and Berry, Professor Colin and Mayne, Dr Kaitlin and Hall Barrientos, Dr Pauline and Allwood-Spiers, Sarah and Lang, Professor Ninian and Lowe, David and Payne, Dr Alexander and Sattar, Professor Naveed
• Authors: Morrow, A. J., Sykes, R., Saleh, M., Zahra, B., MacIntosh, A., Kamdar, A., Bagot, C., Bayes, H. K., Blyth, K. G., Bulluck, H., Carrick, D., Church, C., Corcoran, D., Findlay, I., Gibson, V. B., Gillespie, L., Grieve, D., Hall Barrientos, P., Ho, A., Lang, N. N., Lowe, D. J., Lennie, V., Macfarlane, P. W., Mayne, K. J., Mark, P. B., McConnachie, A., McGeoch, R., Nordin, S., Payne, A., Rankin, A. J., Robertson, K., Ryan, N., Roditi, G., Sattar, N., Stobo, D., Allwood-Spiers, S., Touyz, R. M., Veldtman, G., Weeden, S., Weir, R., Watkins, S., Welsh, P., Mangion, K., and Berry, C.
• College/School: College of Medical Veterinary and Life Sciences; College of Medical Veterinary and Life Sciences > School of Cancer Sciences; College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre; College of Medical Veterinary and Life Sciences > School of Infection & Immunity; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Communications Medicine
• Publisher: Nature Research
• ISSN: 2730-664X
• ISSN (Online): 2730-664X
• Copyright Holders: Copyright: © The Author(s) 2024
• First Published: First published in Communications Medicine 4: 32
• Publisher Policy: Reproduced under a Creative Commons licence

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
311300		CSO covid 19 portfolio	Iain McInnes	Office of the Chief Scientific Adviser (CSO)	COV/GLA/Portfolio	SII - Immunology & Infection
303944		BHF Centre of Excellence	Colin Berry	British Heart Foundation (BHF)	RE/18/6/34217	SCMH - Cardiovascular & Metabolic Health