1. COVID-19 patients' ZIP codes may affect hospitalization outcomes
Patients from high-vulnerability neighborhoods presented to the hospital sicker, in need of more intensive care, but were not any more likely to die in the hospital
Policies needed to identify and address issues that contribute to these health disparities
Abstract: https://www.acpjournals.org/doi/10.7326/M21-2615
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A pooled cross-sectional study found that COVID-19 patients' ZIP codes may affect clinical outcomes. Those in high-vulnerability neighborhoods presented to the hospital with more severe illness and more often required intensive care compared to those in low-vulnerability ZIP codes. The authors suggest policies targeting socially vulnerable neighborhoods to improve access to COVID-19 testing, treatment, and vaccination, as well as to identify and address issues that contribute to such disparities. The study is published in Annals of Internal Medicine.
Differences in COVID-19 illness severity and outcomes, including rates of hospitalization and mortality, have been demonstrated to be related to patient race, ethnicity, and location. The study authors previously found that U.S. counties with higher levels of social vulnerability or disadvantage—based on socioeconomic status, housing, and other factors—experienced greater COVID-19 incidence and mortality.
Researchers from the University of Michigan studied health data for 2,678 patients hospitalized with COVID-19 at 38 Michigan hospitals to determine whether COVID-19 hospitalization outcomes are related to neighborhood-level social vulnerability, independent of patient-level clinical factors. Patient data was assessed in combination with a ZIP code-linked social vulnerability index (SVI), a composite measure of social disadvantage. The authors found that patients living in high-vulnerability ZIP codes had lower pulse oximetry readings and higher respiratory rates upon admission compared to patients living in less vulnerable ZIP codes. Once admitted, they were more likely to receive mechanical ventilation, experience acute organ dysfunction, and develop acute organ failure even after adjusting for individual patient clinical characteristics, suggesting that the neighborhood social disadvantage effects observed were independent of individual-level factors related to patients' age and preexisting comorbid conditions. The authors noted that once the patients were hospitalized, however, they did not experience differences in hospital mortality or discharge disposition. According to the authors, these finding should inform future COVID-19 policies in socially vulnerable neighborhoods.
