Sociodemographic variables as predictors of adverse outcome in SARS-CoV-2 infection: an Irish hospital experience

• Published in: Irish journal of medical science Vol. 190; no. 3; pp. 893 - 903
• Main Authors: Farrell, Richard J., O’Regan, Rhea, O’Neill, Eoghan, Bowens, Grainne, Maclellan, Anne, Gileece, Anne, Bradley, Maeve, Smyth, Claire, Kelly, Orlaith, Hall, Barry, Cormican, Liam, Faul, John, Wanic, Krzysztof, McDermott, John, Sreenan, Seamus, Tun, Tommy Kyaw, Duffy, Trevor, Bhatti, Azhar Iqbal, Donohoe, Orla, Leen, Eamon, Collins, Niamh, McGeary, Shane, Cody, Catriona, Dolan, Eamon, Burke, Conor
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.08.2021
• Subjects: COVID-19 - mortality; Family Medicine; Female; General Practice; Hospital Mortality; Hospitalization; Hospitals; Humans; Internal Medicine; Ireland; Male; Medicine; Medicine & Public Health; Original; Original Article; Pandemics; Risk Factors; SARS-CoV-2; Ireland; COVID-19; Obesity; Clinical care; Ethnicity; Socioeconomic deprivation; Outcomes
• ISSN: 0021-1265; 1863-4362
• DOI: 10.1007/s11845-020-02407-z

Introduction Our hospital found itself at the epicentre of the Irish COVID-19 pandemic. We describe the organisational challenges faced in managing the surge and identified risk factors for mortality and ICU admission among hospitalised SARS-CoV-2-infected patients. Methods All hospitalised SARS-CoV-2 patients diagnosed between March 13 and May 1, 2020, were included. Demographic, referral, deprivation, ethnicity and clinical data were recorded. Multivariable regression, including age-adjusted hazard ratios (HR (95% CI), was used to explore risk factors associated with adverse outcomes. Results Of 257 inpatients, 174 were discharged (68%) and 39 died (15%) in hospital. Two hundred three (79%) patients presented from the community, 34 (13%) from care homes and 20 (8%) were existing inpatients. Forty-five percent of community patients were of a non-Irish White or Black, Asian or minority ethnic (BAME) population, including 34 Roma (13%) compared to 3% of care home and 5% of existing inpatients, ( p  < 0.001). Twenty-two patients were healthcare workers (9%). Of 31 patients (12%) requiring ICU admission, 18 were discharged (58%) and 7 died (23%). Being overweight/obese HR (95% CI) 3.09 (1.32, 7.23), p  = 0.009; a care home resident 2.68 (1.24, 5.6), p  = 0.012; socioeconomically deprived 1.05 (1.01, 1.09), p  = 0.012; and older 1.04 (1.01, 1.06), p  = 0.002 were significantly associated with death. Non-Irish White or BAME were not significantly associated with death 1.31 (0.28, 6.22), p  = 0.63 but were significantly associated with ICU admission 4.38 (1.38, 14.2), p  = 0.014 as was being overweight/obese 2.37 (1.37, 6.83), p  = 0.01. Conclusion The COVID-19 pandemic posed unprecedented organisational issues for our hospital resulting in the greatest surge in ICU capacity above baseline of any Irish hospital. Being overweight/obese, a care home resident, socioeconomically deprived and older were significantly associated with death, while ethnicity and being overweight/obese were significantly associated with ICU admission.