Sociodemographic variables as predictors of adverse outcome in SARS-CoV-2 infection: an Irish hospital experience
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ORIGINAL ARTICLE
Sociodemographic variables as predictors of adverse outcome in SARS-CoV-2 infection: an Irish hospital experience Richard J. Farrell 1 & Rhea O’Regan 1 & Eoghan O’Neill 2 & Grainne Bowens 2 & Anne Maclellan 2 & Anne Gileece 2 & Maeve Bradley 1 & Claire Smyth 1 & Orlaith Kelly 1 & Barry Hall 1 & Liam Cormican 1 & John Faul 1 & Krzysztof Wanic 1 & John McDermott 1 & Seamus Sreenan 1 & Tommy Kyaw Tun 1 & Trevor Duffy 1 & Azhar Iqbal Bhatti 1 & Orla Donohoe 1 & Eamon Leen 3 & Niamh Collins 4 & Shane McGeary 5 & Catriona Cody 5 & Eamon Dolan 1 & Conor Burke 1 Received: 17 June 2020 / Accepted: 15 October 2020 # Royal Academy of Medicine in Ireland 2020
Abstract 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-CoV2-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. Keywords Clinical care . COVID-19 . Ethnicity . Obesity . Outcomes . Socioeconomic deprivation
* Richard J. Farrell [email protected] 1
Departments of Medicine, Connolly Hospital, Ireland and Royal College of Surgeons Ireland, Dublin, Ireland
2
Departments of Microbiology, Connolly Hospital, Ireland and Royal College of Surgeons Irelan
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