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Epidemiological characteristics and outcomes of COVID-19 cases: mortality inequalities by socio-economic status, Barcelona, Spain, 24 February to 4 May 2020
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View Affiliations Hide AffiliationsPatricia Garcia de Olallapolalla aspb.cat
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COVID-19 Surveillance Working Group of Barcelona: Anna de Andres, Dolores Alamo-Junquera, Carmen Gallego, Daniel G Abiétar, Montse Guillaumes, Joan P Millet, Emilia Molinero, Daniela Pérez León, Raquel Rodríguez, Miriam Ros, Andrés Antón, Xavier Martínez-Gómez, Tomás Pumarola, Magda Campins, Virginia Pomar, Ferran Navarro, Teresa Puig, Marta Blazquez, Inmaculada Soriano, Lourdes Barón, Clara Marín, Laura de la Torre, Xavier Castells, Margarita Posso, Juan P Horcajada, Maria A Vàrez, Laia Sentís, Miquel Gómez, Leonor Invernon, Eduardo Padilla, Mara Karaim, Noel Bordon, Francesc Fatjò, Cristina Berbel, Isabel González-Nieto, José L González, Iván Pelegrín, Eva Bargalló, Antoni Salas, Maria C Planes, Gloria García, Diego de Mendoza, Sònia Tortajada, Natàlia Juan, Jordi CasabonView Citation Hide Citation
Citation style for this article: . Epidemiological characteristics and outcomes of COVID-19 cases: mortality inequalities by socio-economic status, Barcelona, Spain, 24 February to 4 May 2020 . Euro Surveill. 2021;26(20):pii=2001138. https://doi.org/10.2807/1560-7917.ES.2021.26.20.2001138 Received: 07 Jun 2020; Accepted: 09 Feb 2021
Abstract
Population-based studies characterising outcomes of COVID-19 in European settings are limited, and effects of socio-economic status (SES) on outcomes have not been widely investigated.
We describe the epidemiological characteristics of COVID-19 cases, highlighting incidence and mortality rate differences across SES during the first wave in Barcelona, Catalonia, Spain.
This population-based study reports individual-level data of laboratory-confirmed COVID-19 cases diagnosed from 24 February to 4 May 2020, notified to the Public Health Agency of Barcelona and followed until 15 June 2020. We analysed end-of-study vital status and the effects of chronic conditions on mortality using logistic regression. Geocoded addresses were linked to basic health area SES data, estimated using the composed socio-economic index. We estimated age-standardised incidence, hospitalisation, and mortality rates by SES.
Of 15,554 COVID-19-confirmed cases, the majority were women (n = 9,028; 58%), median age was 63 years (interquartile range: 46–83), 8,046 (54%) required hospitalisation, and 2,287 (15%) cases died. Prevalence of chronic conditions varied across SES, and multiple chronic conditions increased risk of death (≥ 3, adjusted odds ratio: 2.3). Age-standardised rates (incidence, hospitalisation, mortality) were highest in the most deprived SES quartile (incidence: 1,011 (95% confidence interval (CI): 975–1,047); hospitalisation: 619 (95% CI: 591–648); mortality: 150 (95% CI: 136–165)) and lowest in the most affluent (incidence: 784 (95% CI: 759–809); hospitalisation: 400 (95% CI: 382–418); mortality: 121 (95% CI: 112–131)).
COVID-19 outcomes varied markedly across SES, underscoring the need to implement effective preventive strategies for vulnerable populations.
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