Social Determinants of Health Correlating with Mechanical Ventilation of COVID-19 Patients: A Multi-Center Observational Study.
International Journal of General Medicine
Importance: Several studies have relayed the disproportionate impact of COVID-19 on marginalized communities; however, few have specifically examined the association between social determinants of health and mechanical ventilation (MV).
Objective: To determine which demographics impact MV rates among COVID-19 patients.
Design: This observational study included COVID-19 patient data from eight hospitals' electronic medical records (EMR) between February 25, 2020, to December 31, 2020. Associations between demographic data and MV rates were evaluated using uni- and multivariate analyses.
Setting: Multicenter (eight hospitals), largest health system in Southeast Michigan.
Participants: Inpatients with a positive RT-PCR for SARS-CoV-2 on nasopharyngeal swab. Exclusion criteria were missing demographic data or non-permanent Michigan residents.
Exposure: Patients were divided into two groups: MV and non-MV.
Main Outcome and Measures: The primary outcome was MV rate per demographic. A multivariate model then predicted the odds of MV per demographic descriptor. Hypotheses were formulated prior to data collection.
Results: Among 11,304 COVID-19 inpatients investigated, 1621 (14.34%) were MV, and 49.96% were male with a mean age of 63.37 years (17.79). Significant social determinants for MV included Black race (40.19% MV vs 31.31% non-MV, p
Conclusions and Relevance: Black race, low socioeconomic status, disability, and non-English-speaking status were significant risk factors for MV from COVID-19. An urgent need remains for a pandemic response program that strategizes care for marginalized communities.
Giovanatti A, Elassar H, Karabon P, Wunderlich-Barillas T, Halalau A. Social Determinants of Health Correlating with Mechanical Ventilation of COVID-19 Patients: A Multi-Center Observational Study. Int J Gen Med. 2021 Nov 20;14:8521-8526. doi: 10.2147/IJGM.S334593. PMID: 34848998; PMCID: PMC8612671.