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

• Published in: PloS one Vol. 18; no. 7; p. e0287636
• Main Authors: McKeown, Declan, McCourt, Angela, Hendrick, Louise, O'Farrell, Anne, Donohue, Fionnuala, Grabowsky, Laurin, Kavanagh, Paul, Garvey, Patricia, O'Donnell, Joan, O'Connor, Lois, Cuddihy, John, Robinson, Matt, O'Reilly, Declan, Staines, Anthony, Johnson, Howard
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 21.07.2023; Public Library of Science (PLoS)
• Subjects: Affluence; Age; Age groups; Analysis; Cohort analysis; Comorbidity; Control; COVID-19; Death; Deprivation; Disease transmission; Diseases; Epidemics; Evaluation; Health aspects; Health risks; Hospitals; Infectious diseases; Influenza; Medicine and Health Sciences; Mortality; Pandemics; People and places; Population; Public health; Public health administration; Relative deprivation; Reporting; Standard deviation; Trends; United Kingdom; Variables; Ireland; United Kingdom; United Kingdom > UK
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0287636

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. 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. 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. 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.