Neighborhood Deprivation and Symptom Burden Among Older Adults After Hospitalization for COVID-19

Abstract

Persistent symptoms following COVID-19 disproportionately affect older adults and may be exacerbated by neighborhood socioeconomic deprivation. We evaluated the association between neighborhood deprivation and symptom burden after COVID-19 hospitalization among 298 older adults from five Connecticut hospitals (June 2020-June 2021). Symptom burden was measured using the Edmonton Symptom Assessment System at baseline and 1, 3, and 6 months post-discharge, while neighborhood deprivation was assessed with the Area Deprivation Index. Using Bayesian linear mixed models adjusted for demographic and clinical factors, we found that residing in high-deprivation neighborhoods (ADI > 9/10; n = 28) was associated with higher symptom burden over the 6-month follow-up period. Adjusted analyses estimated a 2.2-point greater mean symptom burden (95% CI: 0.1-4.2). These findings suggest that neighborhood socioeconomic factors may significantly contribute to the persistence of COVID-19 symptoms in older adults, underscoring the need for targeted post-discharge care strategies.

Keywords: COVID-19; deprivation; neighborhoods; older adults; patient-centered outcomes.