Social Determinants of Health Correlating with Mechanical Ventilation of COVID-19 Patients: A Multi-Center Observational Study

Alexa Giovanatti,1 Heba Elassar,2 Patrick Karabon,3 Tracy Wunderlich-Barillas,3 Alexandra Halalau2 1Internal Medicine Department, Beaumont Health, Royal Oak, MI, USA; 2Internal Medicine Department, Oakland University William Beaumont School of Medicine, Rochester, MI, USA; 3Office of Research, Oakla...

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Autores principales:	Giovanatti A, Elassar H, Karabon P, Wunderlich-Barillas T, Halalau A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	covid-19 disparities mechanical ventilation ethnicity socioeconomic Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/d126750ac90e472b94fc71edee9fa355
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spelling	oai:doaj.org-article:d126750ac90e472b94fc71edee9fa3552021-11-21T19:08:51ZSocial Determinants of Health Correlating with Mechanical Ventilation of COVID-19 Patients: A Multi-Center Observational Study1178-7074https://doaj.org/article/d126750ac90e472b94fc71edee9fa3552021-11-01T00:00:00Zhttps://www.dovepress.com/social-determinants-of-health-correlating-with-mechanical-ventilation--peer-reviewed-fulltext-article-IJGMhttps://doaj.org/toc/1178-7074Alexa Giovanatti,1 Heba Elassar,2 Patrick Karabon,3 Tracy Wunderlich-Barillas,3 Alexandra Halalau2 1Internal Medicine Department, Beaumont Health, Royal Oak, MI, USA; 2Internal Medicine Department, Oakland University William Beaumont School of Medicine, Rochester, MI, USA; 3Office of Research, Oakland University William Beaumont School of Medicine, Rochester, MI, USACorrespondence: Alexa GiovanattiBeaumont Health, 3601 W 13 Mile Road, Royal Oak, MI, 48073, USATel +1 248-898-5000Email alexa.giovanatti@beaumont.orgImportance: 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< 0.01), poverty (14.60% vs. 13.21%, p< 0.01), and disability (12.65% vs 9.14%; p< 0.01). Black race (AOR 1.61 (CI 1.41– 1.83; p< 0.01)), median income (AOR 0.99 (CI 0.99– 0.99; p< 0.01)), disability (AOR 1.55 (CI 1.26, 1.90; p< 0.01)), and non-English-speaking status (AOR 1.26 (CI 1.05, 1.53)) had significantly higher odds of MV.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.Keywords: COVID-19, disparities, mechanical ventilation, race, socioeconomicGiovanatti AElassar HKarabon PWunderlich-Barillas THalalau ADove Medical Pressarticlecovid-19disparitiesmechanical ventilationethnicitysocioeconomicMedicine (General)R5-920ENInternational Journal of General Medicine, Vol Volume 14, Pp 8521-8526 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	covid-19 disparities mechanical ventilation ethnicity socioeconomic Medicine (General) R5-920
spellingShingle	covid-19 disparities mechanical ventilation ethnicity socioeconomic Medicine (General) R5-920 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
description	Alexa Giovanatti,1 Heba Elassar,2 Patrick Karabon,3 Tracy Wunderlich-Barillas,3 Alexandra Halalau2 1Internal Medicine Department, Beaumont Health, Royal Oak, MI, USA; 2Internal Medicine Department, Oakland University William Beaumont School of Medicine, Rochester, MI, USA; 3Office of Research, Oakland University William Beaumont School of Medicine, Rochester, MI, USACorrespondence: Alexa GiovanattiBeaumont Health, 3601 W 13 Mile Road, Royal Oak, MI, 48073, USATel +1 248-898-5000Email alexa.giovanatti@beaumont.orgImportance: 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< 0.01), poverty (14.60% vs. 13.21%, p< 0.01), and disability (12.65% vs 9.14%; p< 0.01). Black race (AOR 1.61 (CI 1.41– 1.83; p< 0.01)), median income (AOR 0.99 (CI 0.99– 0.99; p< 0.01)), disability (AOR 1.55 (CI 1.26, 1.90; p< 0.01)), and non-English-speaking status (AOR 1.26 (CI 1.05, 1.53)) had significantly higher odds of MV.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.Keywords: COVID-19, disparities, mechanical ventilation, race, socioeconomic
format	article
author	Giovanatti A Elassar H Karabon P Wunderlich-Barillas T Halalau A
author_facet	Giovanatti A Elassar H Karabon P Wunderlich-Barillas T Halalau A
author_sort	Giovanatti A
title	Social Determinants of Health Correlating with Mechanical Ventilation of COVID-19 Patients: A Multi-Center Observational Study
title_short	Social Determinants of Health Correlating with Mechanical Ventilation of COVID-19 Patients: A Multi-Center Observational Study
title_full	Social Determinants of Health Correlating with Mechanical Ventilation of COVID-19 Patients: A Multi-Center Observational Study
title_fullStr	Social Determinants of Health Correlating with Mechanical Ventilation of COVID-19 Patients: A Multi-Center Observational Study
title_full_unstemmed	Social Determinants of Health Correlating with Mechanical Ventilation of COVID-19 Patients: A Multi-Center Observational Study
title_sort	social determinants of health correlating with mechanical ventilation of covid-19 patients: a multi-center observational study
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/d126750ac90e472b94fc71edee9fa355
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Social Determinants of Health Correlating with Mechanical Ventilation of COVID-19 Patients: A Multi-Center Observational Study

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