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Open accessJournal ArticleDOI: 10.1177/0020731421994842

Assessing the Impact of Individual Characteristics and Neighborhood Socioeconomic Status During the COVID-19 Pandemic in the Provinces of Milan and Lodi.

02 Mar 2021-International Journal of Health Services (SAGE PublicationsSage CA: Los Angeles, CA)-Vol. 51, Iss: 3, pp 20731421994842-20731421994842
Abstract: Social inequalities in health are known to be influenced by the socioeconomic status of the territory in which people live. In the context of the ongoing coronavirus disease 2019 (COVID-19) pandemic, this study is aimed at assessing the role of 5 area-level indicators in shaping the risk of contagion in the provinces of Milan and Lodi (Lombardy, Italy), namely: educational disadvantage, unemployment, housing crowding, mobility, and population density. The study area includes the municipalities at the origin of the first Italian epidemic outbreak. Data on COVID-19 patients from the Integrated Datawarehouse for COVID Analysis in Milan were used and matched with aggregate-level data from the National Institute of Statistics Italy (Istat). Multilevel logistic regression models were used to estimate the association between the census block-level predictors and COVID-19 infection, independently of age, sex, country of birth, and preexisting health conditions. All the variables were significantly associated with the outcome, with different effects before and after the lockdown and according to the province of residence. This suggests a pattern of socioeconomic inequalities in the outbreak, which should be taken into account in the eventuality of future epidemics to contain their spread and its related disparities.

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Topics: Socioeconomic status (51%)
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Open accessJournal ArticleDOI: 10.3390/VACCINES9060538
21 May 2021-Vaccine
Abstract: The COVID-19 pandemic has evidenced the chronic inequality that exists between populations and communities as regards global healthcare. Vaccination, an appropriate tool for the prevention of infection, should be guaranteed by means of proportionate interventions to defeat such inequality in populations and communities affected by a higher risk of infection. Equitable criteria of justice should be identified and applied with respect to access to vaccination and to the order in which it should be administered. This article analyzes, as regards the worldwide distribution of anti-COVID-19 vaccines, the various ways the principle of equity has been construed and applied or even overlooked. The main obstacle to equal access to vaccines is vaccine nationalism. The perception of equity varies with the differing reference values adopted. Adequate response to needs appears to be the principal rule for achieving the criterion of equity in line with distributive justice. Priorities must be set equitably based on rational parameters in accordance with current needs. The entire process must be governed by transparency, from parameter identification to implementation. The issue of equal access to vaccination affects the entire world population, necessitating specific protective interventions. In light of this, the World Health Organization (WHO) has devised the COVAX plan to ensure that even the poorest nations of the world receive the vaccine; certain initiatives are also supported by the European Union (EU). This pandemic has brought to the fore the need to build a culture of equitable relationships both in each country's own domain and with the rest of the world.

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Topics: European union (54%), Equity (economics) (54%), Economic Justice (52%) ... show more

8 Citations


Open accessPosted ContentDOI: 10.1101/2021.05.07.21256725
10 May 2021-medRxiv
Abstract: BackgroundCOVID-19 is suggested to be more prevalent among ethnic minorities and individuals with low socioeconomic status. We aimed to investigate the prevalence of SARS-CoV-2 antibodies during the COVID-19 pandemic among citizens 15 years or older in Denmark living in social housing (SH) areas. MethodsAs part of "Testing Denmark", a nationwide sero-epidemiological surveillance survey, we conducted a study between January 8th and January 31st, 2021 with recruitment in 13 selected SH areas in Denmark. Participants were offered a point-of-care rapid SARS-CoV-2 IgM and IgG antibody test and a questionnaire concerning previous testing (viral throat- and nasopharyngeal swab or antibody test), test results for COVID-19, demographics, household characteristics, employment, risk factors for SARS-CoV-2 infection and history of symptoms associated with COVID-19. Data on seroprevalence from Danish blood donors in same period using a total Ig ELISA assay were used as a proxy for the general Danish population. FindingsOf the 13,279 included participants, 2,296 (17.3%) were seropositive (mean age 46.6 (SD 16.4) years, 54.2% female), which was 3 times higher than in the general Danish population (mean age 41.7 (SD 14.1) years, 48.5% female) in the same period (5.8%, risk ratios (RR) 2.96, 95% CI 2.78-3.16, p>0.001). Seropositivity was higher among males than females (RR 1.1, 95% CI 1.05-1.22%, p=0.001) and increased with age, with an OR seropositivity of 1.03 for each 10-year increase in age (95% CI 1.00-1.06, p=0.031). Close contact with COVID-19-infected individuals was associated with a higher risk of infection, especially among members of the same households (OR 5.0, 95% CI 4.1-6.2 p<0,001). Adjusted for age, gender and region living at least 4 people in a household significantly increased the OR of seropositivity (OR 1.3, 95% CI 1.1-1.6, p=0.02) as did living in a multi-generational household (OR 1.3 per generation, 95% CI 1.1-1.5, p=0.007). Only 1.6% of participants reported not following any of the national COVID-19 recommendations. Anosmia (RR 3.2 95% CI 2.8-3.7, p<0.001) and ageusia (RR 3.3, 95% CI 2.9-3.8, p<0.001) were strongest associated with seropositivity. InterpretationDanish citizens living in SH areas of low socioeconomic status had a three times higher SARS-CoV-2 seroprevalence compared to the general Danish population. The seroprevalence was significantly higher in males and increased with age. Living in multiple generations or more than four persons in a household was an independent risk factor for being seropositive. Results of this study can be used for future consideration of the need for preventive measures in the populations living in SH areas.

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Topics: Seroprevalence (54%), Risk factor (51%)

2 Citations


Open accessPosted ContentDOI: 10.1101/2021.06.08.21258587
12 Jun 2021-medRxiv
Abstract: Background Obesity has been associated with more severe clinical manifestations of coronavirus disease 2019 (COVID-19). However, this association can be affected by many correlates of these traits. Due to its large impact on human health, socioeconomic status (SES) could at least partially influence the association between obesity and COVID-19 severity. To estimate the independent effect of traits related to body size and SES on the clinical manifestations of COVID-19, we conducted a Mendelian randomization (MR) study analyzing the effect of obesity-related anthropometric traits on COVID-19 outcomes. Methods Applying two-sample MR approaches, we evaluated the effects of body mass index (BMI), waist circumference (WC), hip circumference, (HIP) and waist-hip ratio (WHR) studied in up to 234,069 participants from the Genetic Investigation of ANthropometric Traits (GIANT) consortium with respect to three COVID-19 outcomes: severe respiratory COVID-19 (5,101 cases vs. 1,383,241 controls), hospitalized COVID-19 (9,986 cases vs. 1,877,672 controls), and COVID-19 infection (38,984 cases vs. 1,644,784 controls) obtained from the COVID-19 Host Genetics Initiative (HGI). Finally, to test the effect of SES using multivariable MR methods, we analyzed genetic data related to self-reported household income (HI) information from 286,301 UK Biobank (UKB) participants. Results BMI and WC were associated with severe respiratory COVID-19 (BMI: OR⍰=⍰1.68 p⍰=⍰0.0004; WC: OR⍰=⍰1.72, p⍰=⍰0.007) and COVID-19 hospitalization (BMI: OR=⍰1.62, p⍰=⍰1.35e-06; WC: OR⍰=⍰1.62, p⍰=⍰0.0001). Also, HIP influenced hospitalized COVID-19 (OR⍰=⍰1.31, p⍰=⍰0.012) and COVID-19 infection (OR⍰=⍰1.18, p⍰=⍰0.002). Conversely, HI was associated with lower odds of severe respiratory COVID-19 (OR⍰=⍰0.57, p⍰=⍰0.011) and hospitalized COVID-19 (OR⍰=⍰0.71, p⍰=⍰0.045). Testing these effects in multivariable MR models, we observed that the effect of these obesity-related anthropometric traits on COVID-19 outcomes is not independent of SES effect assessed as HI. Conclusions Our findings indicate that low SES is a contributor to the observed association between body size and COVID-19 outcomes.

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Journal ArticleDOI: 10.1177/00207314211044991
Abstract: After more than 1 year from the beginning of the pandemic, the coronavirus disease 2019 (COVID-19) has reached all continents. The number of infected people is still increasing, and Brazil is among the countries with the highest number of registered cases in the world. In this study, we investigated the profile of hospitalized COVID-19 cases and the eventual clusters of similar areas, using geographic information systems. The study was conducted using secondary data. Variables such as sociodemographic characteristics, comorbidities, hospitalization, signs, and symptoms among confirmed cases were considered for each microregion/city of the state of Rio de Janeiro. These proportions were used when calculating the Global Moran's I. The local indicator of spatial association was used to identify local clusters. A significant global spatial auto correlation was found in 28% of the variables. The presence of spatial autocorrelation indicates that the proportions of patients with COVID-19 according to these characteristics are spatially oriented. Moran maps reveal 2 clusters, 1 of high proportions and 1 of low proportions. Understanding the geographic patterns of COVID-19 may assist public health investigators, contributing to actions to prevent and control the pandemic in the state.

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Open accessJournal ArticleDOI: 10.1016/J.UCLIM.2021.100948
Wenhua Yu1, Rongbin Xu1, Tingting Ye1, Chunlei Han2  +4 moreInstitutions (3)
01 Sep 2021-urban climate
Abstract: Objectives To identify the associations of temperature with non-COVID-19 mortality and all-cause mortality in the pandemic 2020 in comparison with the non-COVID-19 period in Italy. Methods The data on 3,189,790 all-cause deaths (including 3,134,137 non-COVID-19 deaths) and meteorological conditions in 107 Italian provinces between February 1st and November 30th in each year of 2015–2020 were collected. We employed a time-stratified case-crossover study design combined with the distributed lag non-linear model to investigate the relationships of temperature with all-cause and non-COVID-19 mortality in the pandemic and non-pandemic periods. Results Cold temperature exposure contributed higher risks for both all-cause and non-COVID-19 mortality in the pandemic period in 2020 than in 2015–2019. However, no different change was found for the impacts of heat. The relative risk (RR) of non-COVID-19 deaths and all-cause mortality at extremely cold (2 °C) in comparison with the estimated minimum mortality temperature (19 °C) in 2020 were 1.63 (95% CI: 1.55–1.72) and 1.45 (95%CI: 1.31–1.61) respectively, which were higher than all-cause mortality risk in 2015–2019 with RR of 1.19 (95%CI: 1.17–1.21). Conclusion Cold exposure indicated stronger impacts than high temperatures on all-cause and non-COVID-19 mortality in the pandemic year 2020 compared to its counterpart period in 2015–2019 in Italy.

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49 results found


Open accessJournal ArticleDOI: 10.1016/S0140-6736(20)30183-5
Chaolin Huang1, Yeming Wang2, Xingwang Li3, Lili Ren4  +25 moreInstitutions (8)
24 Jan 2020-The Lancet
Abstract: A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not.

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26,390 Citations


Open accessBook
01 Jan 1979-
Abstract: Preface to the English-Language Edition Introduction Part 1: A Social Critique of the Judgement of Taste 1. The Aristocracy of Culture Part 2: The Economy of Practices 2. The Social Space and its Transformations 3. The Habitus and the Space of Life-Styles 4. The Dynamics of Fields Part 3: Class Tastes and Life-Styles 5. The Sense of Distinction 6. Cultural Good Will 7. The Choice of the Necessary 8. Culture and Politics Conclusion: Classes and Classifications Postscript: Towards a 'Vulgar' Critique of 'Pure' Critiques Appendices Notes Credits Index

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Topics: Judgement (57%), Taste (sociology) (57%), Habitus (52%) ... show more

23,791 Citations



Open accessJournal ArticleDOI: 10.1056/NEJMOA2002032
Wei-jie Guan1, Zhengyi Ni1, Yu Hu1, Wenhua Liang1  +33 moreInstitutions (1)
Abstract: Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of...

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16,855 Citations


Open accessJournal ArticleDOI: 10.1016/S0140-6736(20)30566-3
Fei Zhou1, Ting Yu, Ronghui Du, Guohui Fan2  +16 moreInstitutions (5)
28 Mar 2020-The Lancet
Abstract: Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

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Topics: Cohort study (56%), Retrospective cohort study (56%), Odds ratio (53%) ... show more

15,279 Citations