Stephen Andrew H, Andrea Sarah B, Banerjee Debasree, Arafeh Mohammed, Askew Morgan, Lueckel Stephanie N, Kheirbek Tareq, Mermel Leonard A, Adams Charles A, Levy Mitchell M, Heffernan Daithi S
Alpert Medical School at Brown University, Division of Trauma and Surgical Critical Care, Department of Surgery, Providence, RI, USA.
Lifespan Biostatistics Epidemiology & Research Design Core, Rhode Island Hospital, Providence, RI, USA.
SSM Popul Health. 2022 Jun 15;19:101133. doi: 10.1016/j.ssmph.2022.101133. eCollection 2022 Sep.
Approaches to COVID-19 mitigation can be more efficiently delivered with a more detailed understanding of where the severe cases occur. Our objective was to assess which demographic, housing and neighborhood characteristics were independently and collectively associated with differing rates of severe COVID-19.
A cohort of patients with SARS-CoV-2 in a single health system from March 1, 2020 to February 15, 2021 was reviewed to determine whether demographic, housing, or neighborhood characteristics are associated with higher rates of severe COVID-19 infections and to create a novel scoring index. Characteristics included proportion of multifamily homes, essential workers, and ages of the homes within neighborhoods.
There were 735 COVID-19 ICU admissions in the study interval which accounted for 61 percent of the state's ICU admissions for COVID-19. Compared to the general population of the state those admitted to the ICU with COVID-19 were disproportionately older, male sex, and were more often Black, Indigenous, People of Color. Patients disproportionately resided in neighborhoods with three plus unit multifamily homes, homes built before 1940, homes with more than one person to a room, homes of lower average value, and in neighborhoods with a greater proportion of essential workers. From this our COVID-19 Neighborhood Index value was comparatively higher for the ICU patients (61.1) relative to the population of Rhode Island (49.4).
COVID-19-related ICU admissions are highly related to demographic, housing and neighborhood-level factors. This may guide more nuanced and targeted vaccine distribution plans and public health measures for future pandemics.
通过更详细地了解重症病例的发生地点，可以更有效地实施缓解新冠疫情的措施。我们的目标是评估哪些人口统计学、住房和社区特征与不同的新冠重症发生率独立相关或共同相关。
对2020年3月1日至2021年2月15日在单一医疗系统中的一组新冠病毒患者进行回顾，以确定人口统计学、住房或社区特征是否与新冠重症感染率较高相关，并创建一个新的评分指数。特征包括多户住宅的比例、 essential workers以及社区内房屋的年代。
在研究期间，有735例新冠患者入住重症监护病房，占该州新冠患者重症监护病房入院人数的61%。与该州的普通人群相比，因新冠入住重症监护病房的患者年龄偏大、男性居多，并且更常为黑人、原住民、有色人种。患者不成比例地居住在有三个及以上单元的多户住宅、1940年以前建造的房屋、一间房住多人的房屋、平均价值较低的房屋所在的社区，以及 essential workers比例较高的社区。由此，我们得出重症监护病房患者的新冠社区指数值（61.1）相对于罗德岛州人口（49.4）较高。
与新冠相关的重症监护病房入院情况与人口统计学、住房和社区层面的因素高度相关。这可能为未来大流行中更细致、有针对性的疫苗分发计划和公共卫生措施提供指导。
