Socio-Demographic Health Determinants Are Associated with Poor Prognosis in Spanish Patients Hospitalized with COVID-19

Martín-Sánchez, F. Javier; Valls Carbó, Adrián; Miró, Òscar; Llorens, Pere; Jiménez, Sònia; Piñera, Pascual; Burillo-Putze, Guillermo; Martín, Alfonso; García-Lamberechts, Jorge E.; Jacob, Javier; Alquézar, Aitor; Martínez-Valero, Carmen; Miranda, Juan de D.; López Picado, Amanda; Arrebola, Juan Pedro; López, Marta Esteban; Parviainen, Annika; González del Castillo, Juan; Miró, Oscar; Jimenez, Sonia; Ferreras Amez, José María; Rubio Díaz, Rafael; Gamazo del Rio, Julio Javier; Alonso, Héctor; Herrero, Pablo; Ruiz de Lobera, Noemí; Ibero, Carlos; Mayan, Plácido; Peinado, Rosario; Navarro Bustos, Carmen; Manzanares, Jesús Álvarez; Román, Francisco; Piñera, Pascual; Burillo, Guillermo; Jacob, Javier; Bibiano, Carlos

INTRODUCTION: Social vulnerability is a known determinant of health in respiratory diseases. Our aim was to identify whether there are socio-demographic factors among COVID-19 patients hospitalized in Spain and their potential impact on health outcomes during the hospitalization. METHODS: A multicentric retrospective case series study based on administrative databases that included all COVID-19 cases admitted in 19 Spanish hospitals from 1 March to 15 April 2020. Socio-demographic data were collected. Outcomes were critical care admission and in-hospital mortality. RESULTS: We included 10,110 COVID-19 patients admitted to 18 Spanish hospitals (median age 68 (IQR 54–80) years old; 44.5% female; 14.8% were not born in Spain). Among these, 779 (7.7%) cases were admitted to critical care units and 1678 (16.6%) patients died during the hospitalization. Age, male gender, being immigrant, and low hospital saturation were independently associated with being admitted to an intensive care unit. Age, male gender, being immigrant, percentile of average per capita income, and hospital experience were independently associated with in-hospital mortality. CONCLUSIONS: Social determinants such as residence in low-income areas and being born in Latin American countries were associated with increased odds of being admitted to an intensive care unit and of in-hospital mortality. There was considerable variation in outcomes between different Spanish centers. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11606-020-06584-6.