Adults residing in socially vulnerable counties in the US are more likely to die or experience serious heart problems when hospitalized for COVID-19 compared to those from less vulnerable areas, according to a new study published in Circulation: Cardiovascular Quality and Outcomes.
Dr. Rishi Wadhera, a cardiologist and assistant professor of medicine at Harvard Medical School in Boston, and colleagues examined the relationship between county-level social vulnerability, in-hospital death rates, and major cardiovascular events in 16,939 adults with COVID-19 admitted to 107 hospitals across the country from January 14- November 30, 2020.
Among the 16,939 COVID-19 patients hospitalized in the registry, approximately 30% resided in the most vulnerable communities. In addition, people in these communities were more likely to be Black adults and Medicaid-insured.
“Throughout this public health crisis, individuals who are more socioeconomically disadvantaged or from minority racial and ethnic backgrounds have disproportionately borne the burden of COVID-19,” said lead study author, Dr. Rishi Wadhera.
The researchers found that patients hospitalized for COVID-19 from the most socially vulnerable counties were 25% more likely to die when hospitalized compared to those from the least vulnerable counties, especially during the pandemic’s early stages. The researchers also found that those from the most vulnerable areas were 26% more likely to experience major heart problems, including cardiac arrest.
According to the study, adults with COVID-19 from the most socially vulnerable counties were also more likely to require a ventilator and other types of medical support when admitted. However, they were less likely than those from the least socially vulnerable counties to receive key therapies, such as steroids.
“It did surprise us that despite being sicker when they came to the hospital, these patients were less likely to receive steroid therapy, an important evidence-based treatment for COVID-19,” he said.
Dr. Wadhera cited several factors that could explain these disparities, including the strain on hospitals in socially vulnerable communities resulting from fewer resources during the crisis and the inequitable dissemination of medical advances across health systems.
“During a public health crisis of this magnitude, we need to ensure that health systems with fewer resources receive the support they need,” Wadhera said, “and that we pull all the public health and policy levers required to protect the most vulnerable patient populations and communities.”
Source: American Heart Association News