Morrow, Andrew J. and Sykes, Robert and Saleh, Merna and Zahra, Baryab and MacIntosh, Alasdair and Kamdar, Anna and Bagot, Catherine and Bayes, Hannah K. and Blyth, Kevin G. and Bulluck, Heerajnarain and Carrick, David and Church, Colin and Corcoran, David and Findlay, Iain and Gibson, Vivienne and Gillespie, Lynsey and Grieve, Douglas and Hall Barrientos, Pauline and Ho, Antonia and Lang, Ninian N. and Lowe, David J. and Lennie, Vera and Macfarlane, Peter W. and Mayne, Kaitlin J. and Mark, Patrick B. and McConnachie, Alex and McGeoch, Ross and Nordin, Sabrina and Payne, Alexander and Rankin, Alastair J. and Robertson, Keith and Ryan, Nicola and Roditi, Giles and Sattar, Naveed and Stobo, David and Allwood-Spiers, Sarah and Touyz, Rhian M. and Veldtman, Gruschen and Weeden, Sarah and Weir, Robin and Watkins, Stuart and Welsh, Paul and Mangion, Kenneth and Berry, Colin (2024) Socioeconomic deprivation and illness trajectory in the Scottish population after COVID-19 hospitalization. Communications Medicine, 4: 32. ISSN 2730-664X

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Abstract

Background
The associations between deprivation and illness trajectory after hospitalisation for coronavirus disease-19 (COVID-19) are uncertain.

Methods
A prospective, multicentre cohort study was conducted on post-COVID-19 patients, enrolled either in-hospital or shortly post-discharge. Two evaluations were carried out: an initial assessment and a follow-up at 28–60 days post-discharge. The study encompassed research blood tests, patient-reported outcome measures, and multisystem imaging (including chest computed tomography (CT) with pulmonary and coronary angiography, cardiovascular and renal magnetic resonance imaging). Primary and secondary outcomes were analysed in relation to socioeconomic status, using the Scottish Index of Multiple Deprivation (SIMD). The EQ-5D-5L, Brief Illness Perception Questionnaire (BIPQ), Patient Health Questionnaire-4 (PHQ-4) for Anxiety and Depression, and the Duke Activity Status Index (DASI) were used to assess health status.

Results
Of the 252 enrolled patients (mean age 55.0 ± 12.0 years; 40% female; 23% with diabetes), deprivation status was linked with increased BMI and diabetes prevalence. 186 (74%) returned for the follow-up. Within this group, findings indicated associations between deprivation and lung abnormalities (p = 0.0085), coronary artery disease (p = 0.0128), and renal inflammation (p = 0.0421). Furthermore, patients with higher deprivation exhibited worse scores in health-related quality of life (EQ-5D-5L, p = 0.0084), illness perception (BIPQ, p = 0.0004), anxiety and depression levels (PHQ-4, p = 0.0038), and diminished physical activity (DASI, p = 0.002). At the 3-month mark, those with greater deprivation showed a higher frequency of referrals to secondary care due to ongoing COVID-19 symptoms (p = 0.0438). However, clinical outcomes were not influenced by deprivation.

Conclusions
In a post-hospital COVID-19 population, socioeconomic deprivation was associated with impaired health status and secondary care episodes. Deprivation influences illness trajectory after COVID-19.

Information
Title Socioeconomic deprivation and illness trajectory in the Scottish population after COVID-19 hospitalization
Creators Morrow, Andrew J. and Sykes, Robert and Saleh, Merna and Zahra, Baryab and MacIntosh, Alasdair and Kamdar, Anna and Bagot, Catherine and Bayes, Hannah K. and Blyth, Kevin G. and Bulluck, Heerajnarain and Carrick, David and Church, Colin and Corcoran, David and Findlay, Iain and Gibson, Vivienne and Gillespie, Lynsey and Grieve, Douglas and Hall Barrientos, Pauline and Ho, Antonia and Lang, Ninian N. and Lowe, David J. and Lennie, Vera and Macfarlane, Peter W. and Mayne, Kaitlin J. and Mark, Patrick B. and McConnachie, Alex and McGeoch, Ross and Nordin, Sabrina and Payne, Alexander and Rankin, Alastair J. and Robertson, Keith and Ryan, Nicola and Roditi, Giles and Sattar, Naveed and Stobo, David and Allwood-Spiers, Sarah and Touyz, Rhian M. and Veldtman, Gruschen and Weeden, Sarah and Weir, Robin and Watkins, Stuart and Welsh, Paul and Mangion, Kenneth and Berry, Colin
Identification Number 10.1038/s43856-024-00455-5
Date 28 February 2024
Divisions College of Medical Veterinary and Life Sciences
College of Medical Veterinary and Life Sciences > School of Cancer Sciences
College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences > School of Infection & Immunity
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Publisher Nature Research
Additional Information CISCO-19 was an investigator-initiated clinical study that was funded by the Chief Scientist Office of the Scottish Government (COV/GLA/Portfolio project number 311300). C.B, C.D., N.S., R.M.T. were supported by the British Heart Foundation (RE/18/6134217).
Library
URI https://pub.demo35.eprints-hosting.org/id/eprint/358
Item Type Article
Depositing User Unnamed user with email ejo1f20@soton.ac.uk
Date Deposited 11 Jun 2025 16:37
Revision 46
Last Modified 12 Jun 2025 10:27
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