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. 2021 May;26(20):2001138.
doi: 10.2807/1560-7917.ES.2021.26.20.2001138.

Epidemiological characteristics and outcomes of COVID-19 cases: mortality inequalities by socio-economic status, Barcelona, Spain, 24 February to 4 May 2020

Julieta Politi  1   2 , Mario Martín-Sánchez  1   2 , Lilas Mercuriali  1 , Blanca Borras-Bermejo  3 , Joaquín Lopez-Contreras  4 , Anna Vilella  5 , Judit Villar  6 ; COVID-19 Surveillance Working Group of Barcelona  7 ; Angels Orcau  1   8   9 , Patricia Garcia de Olalla  1   10   8   9 , Cristina Rius  1   11   8   9
Collaborators, Affiliations

Epidemiological characteristics and outcomes of COVID-19 cases: mortality inequalities by socio-economic status, Barcelona, Spain, 24 February to 4 May 2020

Julieta Politi et al. Euro Surveill. 2021 May.

Abstract

BackgroundPopulation-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. AimWe describe the epidemiological characteristics of COVID-19 cases, highlighting incidence and mortality rate differences across SES during the first wave in Barcelona, Catalonia, Spain.MethodsThis 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.ResultsOf 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)).ConclusionsCOVID-19 outcomes varied markedly across SES, underscoring the need to implement effective preventive strategies for vulnerable populations.

Keywords: SARS-CoV-2; epidemiology; health inequalities; mortality; socio-economic status; surveillance.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure
Figure
Epidemic curve of laboratory-confirmed COVID-19 cases notified to the Public Health Agency of Barcelona, Spain, 24 February–4 May 2020 (n = 15,554)
See this image and copyright information in PMC

References

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