Community Medicine Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Public Health. 2022 May 10;22(1):927. doi: 10.1186/s12889-022-13290-x.
It remains crucial to understand socio-demographic determinants of COVID-19 infection to improve access to care and recovery rates from the disease. This study aimed to investigate the urban and sub-urban disparities associated with COVID-19 in patients visiting healthcare facilities in the province of Tehran, Iran.
Data from 234 418 patients who were diagnosed with COVID-19 infection from March 2020 to March 2021 in the province of Tehran were used in this analysis. Descriptive statistics were used to describe the characteristics of the study population. Chi-Squared test was applied to examine the association of study variables with residing area. Independent samples t-test was performed to compare mean age of patients in urban and sub-urban areas. Multiple Logistic Regression model was applied to examine the association of study variables with disease outcome.
Overall, most patients resided in the urban settings (73%). Mean age of patients was significantly lower in sub-urban areas compared to their counterparts in urban settings (49 ± 23.1 years versus 53 ± 21.1 years, P < 0.001). Positive PCR test results were more common in urban areas (48.5% versus 41.3%, P < 0.001). Yet, sub-urban settings had higher rates of positive chest CT scan reports (62.8% versus 53.4%, P < 0.001). After accounting for age and sex covariates, residing in urban areas was associated with higher likelihood of being admitted to an ICU (OR = 1.27, CI: 1.240-1.305). Yet, a greater vulnerability to fatal outcome of COVID-19 infection was shown in patients living in sub-urban areas (OR = 1.13, CI: 1.105-1.175).
This study revealed a clear disparity in the health outcome of patients infected with COVID-19 between urban and sub-urban areas.
了解 COVID-19 感染的社会人口决定因素对于改善获得医疗服务和疾病康复率仍然至关重要。本研究旨在调查伊朗德黑兰省医疗设施就诊的 COVID-19 患者中与城市和郊区相关的差异。
本分析使用了 2020 年 3 月至 2021 年 3 月期间在德黑兰省被诊断患有 COVID-19 感染的 234418 名患者的数据。描述性统计用于描述研究人群的特征。卡方检验用于检查研究变量与居住区域的关联。独立样本 t 检验用于比较城市和郊区患者的平均年龄。多因素逻辑回归模型用于检查研究变量与疾病结局的关联。
总体而言，大多数患者居住在城市地区（73%）。与城市地区的患者相比，郊区地区的患者年龄明显较小（49±23.1 岁比 53±21.1 岁，P<0.001）。城市地区的 PCR 检测结果阳性率更高（48.5%比 41.3%，P<0.001）。然而，郊区地区的胸部 CT 扫描阳性报告率更高（62.8%比 53.4%，P<0.001）。在考虑年龄和性别协变量后，居住在城市地区与更高的 ICU 入院几率相关（OR=1.27，CI：1.240-1.305）。然而，郊区地区的 COVID-19 感染死亡率更高（OR=1.13，CI：1.105-1.175）。
本研究揭示了城市和郊区 COVID-19 感染患者的健康结局存在明显差异。
