Dataset Information

Influence of socio-economic status on functional recovery after ARDS caused by SARS-CoV-2: the multicentre, observational RECOVIDS study.

ABSTRACT:

Purpose

Survivors after acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19) are at high risk of developing respiratory sequelae and functional impairment. The healthcare crisis caused by the pandemic hit socially disadvantaged populations. We aimed to evaluate the influence of socio-economic status on respiratory sequelae after COVID-19 ARDS.

Methods

We carried out a prospective multicenter study in 30 French intensive care units (ICUs), where ARDS survivors were pre-enrolled if they fulfilled the Berlin ARDS criteria. For patients receiving high flow oxygen therapy, a flow ≥ 50 l/min and an FiO₂ ≥ 50% were required for enrollment. Socio-economic deprivation was defined by an EPICES (Evaluation de la Précarité et des Inégalités de santé dans les Centres d'Examens de Santé - Evaluation of Deprivation and Inequalities in Health Examination Centres) score ≥ 30.17 and patients were included if they performed the 6-month evaluation. The primary outcome was respiratory sequelae 6 months after ICU discharge, defined by at least one of the following criteria: forced vital capacity < 80% of theoretical value, diffusing capacity of the lung for carbon monoxide < 80% of theoretical value, oxygen desaturation during a 6-min walk test and fibrotic-like findings on chest computed tomography.

Results

Among 401 analyzable patients, 160 (40%) were socio-economically deprived and 241 (60%) non-deprived; 319 (80%) patients had respiratory sequelae 6 months after ICU discharge (81% vs 78%, deprived vs non-deprived, respectively). No significant effect of socio-economic status was identified on lung sequelae (odds ratio (OR), 1.19 [95% confidence interval (CI), 0.72-1.97]), even after adjustment for age, sex, most invasive respiratory support, obesity, most severe P/F ratio (adjusted OR, 1.02 [95% CI 0.57-1.83]).

Conclusions

In COVID-19 ARDS survivors, socio-economic status had no significant influence on respiratory sequelae 6 months after ICU discharge.

SUBMITTER: Declercq PL

PROVIDER: S-EPMC10556111 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Influence of socio-economic status on functional recovery after ARDS caused by SARS-CoV-2: the multicentre, observational RECOVIDS study.

Declercq Pierre-Louis PL Fournel Isabelle I Demeyere Matthieu M Berraies Anissa A Ksiazek Eléa E Nyunga Martine M Daubin Cédric C Ampere Alexandre A Sauneuf Bertrand B Badie Julio J Delbove Agathe A Nseir Saad S Artaud-Macari Elise E Bironneau Vanessa V Ramakers Michel M Maizel Julien J Miailhe Arnaud-Felix AF Lacombe Béatrice B Delberghe Nicolas N Oulehri Walid W Georges Hugues H Tchenio Xavier X Clarot Caroline C Redureau Elise E Bourdin Gaël G Federici Laura L Adda Mélanie M Schnell David D Bousta Mehdi M Salmon-Gandonnière Charlotte C Vanderlinden Thierry T Plantefeve Gaëtan G Delacour David D Delpierre Cyrille C Le Bouar Gurvan G Sedillot Nicholas N Beduneau Gaëtan G Rivière Antoine A Meunier-Beillard Nicolas N Gélinotte Stéphanie S Rigaud Jean-Philippe JP Labruyère Marie M Georges Marjolaine M Binquet Christine C Quenot Jean-Pierre JP

Intensive care medicine 20230824 10

<h4>Purpose</h4>Survivors after acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19) are at high risk of developing respiratory sequelae and functional impairment. The healthcare crisis caused by the pandemic hit socially disadvantaged populations. We aimed to evaluate the influence of socio-economic status on respiratory sequelae after COVID-19 ARDS.<h4>Methods</h4>We carried out a prospective multicenter study in 30 French intensive care units (ICUs), where ARD ...[more]

PMID: 37620561

Similar Datasets

Project description:IntroductionPrognosis of patients with COVID-19 depends on the severity of the pulmonary affection. The most severe cases may progress to acute respiratory distress syndrome (ARDS), which is associated with a risk of long-term repercussions on respiratory function and neuromuscular outcomes. The functional repercussions of severe forms of COVID-19 may have a major impact on quality of life, and impair the ability to return to work or exercise. Social inequalities in healthcare may influence prognosis, with socially vulnerable individuals more likely to develop severe forms of disease. We describe here the protocol for a prospective, multicentre study that aims to investigate the influence of social vulnerability on functional recovery in patients who were hospitalised in intensive care for ARDS caused by COVID-19. This study will also include an embedded qualitative study that aims to describe facilitators and barriers to compliance with rehabilitation, describe patients' health practices and identify social representations of health, disease and care.Methods and analysisThe "Functional Recovery From Acute Respiratory Distress Syndrome (ARDS) Due to COVID-19: Influence of Socio-Economic Status" (RECOVIDS) study is a mixed-methods, observational, multicentre cohort study performed during the routine follow-up of post-intensive care unit (ICU) functional recovery after ARDS. All patients admitted to a participating ICU for PCR-proven SARS-CoV-2 infection and who underwent chest CT scan at the initial phase AND who received respiratory support (mechanical or not) or high-flow nasal oxygen, AND had ARDS diagnosed by the Berlin criteria will be eligible. The primary outcome is the presence of lung sequelae at 6 months after ICU discharge, defined either by alterations on pulmonary function tests, oxygen desaturation during a standardised 6 min walk test or fibrosis-like pulmonary findings on chest CT. Patients will be considered to be socially disadvantaged if they have an "Evaluation de la Précarité et des Inégalités de santé dans les Centres d'Examen de Santé" (EPICES) score ≥30.17 at inclusion.Ethics and disseminationThe study protocol and the informed consent form were approved by an independent ethics committee (Comité de Protection des Personnes Sud Méditerranée II) on 10 July 2020 (2020-A02014-35). All patients will provide informed consent before participation. Findings will be published in peer-reviewed journals and presented at national and international congresses.Trial registration numberNCT04556513.

Project description:Since its outbreak, COVID-19 disease has claimed over one hundred thousand lives in the United States, resulting to multiple and complex nation-wide challenges. In this study, we employ global and local regression models to assess the influence of socio-economic and health conditions on COVID-19 mortality in contiguous USA. For a start, stepwise and exploratory regression models were employed to isolate the main explanatory variables for COVID-19 mortality from the ensemble 33 socio-economic and health parameters between January 1st and 16th of September 2020. Preliminary results showed that only five out of the examined variables (case fatality rate, vulnerable population, poverty, percentage of adults that report no leisure-time physical activity, and percentage of the population with access to places for physical activity) can explain the variability of COVID-19 mortality across the Counties of contiguous USA within the study period. Consequently, we employ three global and two local regression algorithms to model the relationship between COVID-19 and the isolated socio-economic and health variables. The outcomes of the regression analyses show that the adopted models can explain 61%-81% of COVID-19 mortality across the contiguous USA within the study period. However, MGWR yielded the highest R2 (0.81) and lowest AICc values (4031), emphasizing that it is the most efficient among the adopted regression models. The computed average adjusted R2 values show that local regression models (mean adj. R2 = 0.80) outperformed the global regression models (mean adj. R2 = 0.64), indicating that the former is ideal for modeling spatial causal relationships. The GIS-based optimized cluster analyses results show that hotspots for COVID-19 mortality as well as socioeconomic variables are mostly delineated in the South, Mid-West and Northeast of contiguous USA. COVID-19 mortality exhibited positive and significant association with black race (0.51), minority (0.48) and poverty (0.34). Whereas, the percentage of persons that attended college was negatively associated with poverty (-0.51), obesity (-0.50) and diabetes (-0.45). Results show that education is crucial to improve socio-economic and health conditions of the Americans. We conclude that investing in people's standard of living would reduce the vulnerability of an entire population.

Project description:BackgroundWe sought to determine whether socio-economic status (SES) is an independent predictor of outcome following total knee (TKR) and hip (THR) replacement in Australians.MethodsIn this prospective cohort study, we included patients undergoing TKR and THR in a public hospital in whom baseline and 12-month follow-up data were available. SES was determined using the Australian Bureau of Statistics 'Index of Relative Advantage and Disadvantage'. Other independent variables included patients' demographics, comorbidities and procedure-related variables. Outcome measures were the International Knee Society Score and Harris Hip Score pain and function subscales, and the Short Form Health Survey (SF-12) physical and mental component scores.ResultsAmong 1,016 patients undergoing TKR and 835 patients undergoing THR, in multiple regression analysis, SES score was not independently associated with pain and functional outcomes. Female sex, older age, being a non-English speaker, higher body mass index and presence of comorbidities were associated with greater post-operative pain and poorer functional outcomes following arthroplasty. Better baseline function, physical and mental health, and lower baseline level of pain were associated with better outcomes at 12 months. In univariate analysis, for TKR, the improvement in SF-12 mental health score post arthroplasty was greater in patients of lower SES (3.8 ± 12.9 versus 1.5 ± 12.2, p=0.008), with a statistically significant inverse association between SES score and post-operative SF-12 mental health score in linear regression analysis (coefficient-0.28, 95% CI: -0.52 to -0.04, p=0.02).ConclusionsWhen adjustments are made for other covariates, SES is not an independent predictor of pain and functional outcome following large joint arthroplasty in Australian patients. However, relative to baseline, patients in lower socioeconomic groups are likely to have greater mental health benefits with TKR than more privileged patients. Large joint arthroplasty should be made accessible to patients of all SES.

Dataset Information

Influence of socio-economic status on functional recovery after ARDS caused by SARS-CoV-2: the multicentre, observational RECOVIDS study.

Purpose

Methods

Results

Conclusions

Publications

Influence of socio-economic status on functional recovery after ARDS caused by SARS-CoV-2: the multicentre, observational RECOVIDS study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets