{"entity": "publication", "iuid": "e423ccc6f6ef417e9c25f79beb912f33", "timestamp": "2023-10-04T22:26:08.284Z", "links": {"self": {"href": "https://publications-covid19.scilifelab.se/publication/e423ccc6f6ef417e9c25f79beb912f33.json"}, "display": {"href": "https://publications-covid19.scilifelab.se/publication/e423ccc6f6ef417e9c25f79beb912f33"}}, "title": "Environmental and societal factors associated with COVID-19-related death in people with rheumatic disease: an observational study.", "authors": [{"family": "Izadi", "given": "Zara", "initials": "Z"}, {"family": "Gianfrancesco", "given": "Milena A", "initials": "MA"}, {"family": "Schmajuk", "given": "Gabriela", "initials": "G"}, {"family": "Jacobsohn", "given": "Lindsay", "initials": "L"}, {"family": "Katz", "given": "Patricia", "initials": "P"}, {"family": "Rush", "given": "Stephanie", "initials": "S"}, {"family": "Ja", "given": "Clairissa", "initials": "C"}, {"family": "Taylor", "given": "Tiffany", "initials": "T"}, {"family": "Shidara", "given": "Kie", "initials": "K"}, {"family": "Danila", "given": "Maria I", "initials": "MI"}, {"family": "Wysham", "given": "Katherine D", "initials": "KD"}, {"family": "Strangfeld", "given": "Anja", "initials": "A"}, {"family": "Mateus", "given": "Elsa F", "initials": "EF"}, {"family": "Hyrich", "given": "Kimme L", "initials": "KL"}, {"family": "Gossec", "given": "Laure", "initials": "L"}, {"family": "Carmona", "given": "Loreto", "initials": "L"}, {"family": "Lawson-Tovey", "given": "Saskia", "initials": "S"}, {"family": "Kearsley-Fleet", "given": "Lianne", "initials": "L"}, {"family": "Schaefer", "given": "Martin", "initials": "M"}, {"family": "Al-Emadi", "given": "Samar", "initials": "S"}, {"family": "Sparks", "given": "Jeffrey A", "initials": "JA"}, {"family": "Hsu", "given": "Tiffany Y-T", "initials": "TY"}, {"family": "Patel", "given": "Naomi J", "initials": "NJ"}, {"family": "Wise", "given": "Leanna", "initials": "L"}, {"family": "Gilbert", "given": "Emily", "initials": "E"}, {"family": "Duarte-Garc\u00eda", "given": "Al\u00ed", "initials": "A"}, {"family": "Valenzuela-Almada", "given": "Maria O", "initials": "MO"}, {"family": "Ugarte-Gil", "given": "Manuel F", "initials": "MF"}, {"family": "Ljung", "given": "Lotta", "initials": "L"}, {"family": "Scir\u00e8", "given": "Carlo A", "initials": "CA"}, {"family": "Carrara", "given": "Greta", "initials": "G"}, {"family": "Hachulla", "given": "Eric", "initials": "E"}, {"family": "Richez", "given": "Christophe", "initials": "C"}, {"family": "Cacoub", "given": "Patrice", "initials": "P"}, {"family": "Thomas", "given": "Thierry", "initials": "T"}, {"family": "Santos", "given": "Maria J", "initials": "MJ"}, {"family": "Bernardes", "given": "Miguel", "initials": "M"}, {"family": "Hasseli", "given": "Rebecca", "initials": "R"}, {"family": "Regierer", "given": "Anne", "initials": "A"}, {"family": "Schulze-Koops", "given": "Hendrik", "initials": "H"}, {"family": "M\u00fcller-Ladner", "given": "Ulf", "initials": "U"}, {"family": "Pons-Estel", "given": "Guillermo", "initials": "G"}, {"family": "Tanten", "given": "Romina", "initials": "R"}, {"family": "Nieto", "given": "Romina E", "initials": "RE"}, {"family": "Pisoni", "given": "Cecilia N", "initials": "CN"}, {"family": "Tissera", "given": "Yohana S", "initials": "YS"}, {"family": "Xavier", "given": "Ricardo", "initials": "R"}, {"family": "Lopes Marques", "given": "Claudia D", "initials": "CD"}, {"family": "Pileggi", "given": "Gecilmara C S", "initials": "GCS"}, {"family": "Robinson", "given": "Philip C", "initials": "PC"}, {"family": "Machado", "given": "Pedro M", "initials": "PM"}, {"family": "Sirotich", "given": "Emily", "initials": "E"}, {"family": "Liew", "given": "Jean W", "initials": "JW"}, {"family": "Hausmann", "given": "Jonathan S", "initials": "JS"}, {"family": "Sufka", "given": "Paul", "initials": "P"}, {"family": "Grainger", "given": "Rebecca", "initials": "R"}, {"family": "Bhana", "given": "Suleman", "initials": "S"}, {"family": "Gore-Massy", "given": "Monique", "initials": "M"}, {"family": "Wallace", "given": "Zachary S", "initials": "ZS"}, {"family": "Yazdany", "given": "Jinoos", "initials": "J"}, {"family": "COVID-19 Global Rheumatology Alliance Registry", "given": "", "initials": ""}], "type": "journal article", "published": "2022-07-25", "journal": {"title": "Lancet Rheumatol", "issn": "2665-9913", "issn-l": null}, "abstract": "Differences in the distribution of individual-level clinical risk factors across regions do not fully explain the observed global disparities in COVID-19 outcomes. We aimed to investigate the associations between environmental and societal factors and country-level variations in mortality attributed to COVID-19 among people with rheumatic disease globally.\n\nIn this observational study, we derived individual-level data on adults (aged 18-99 years) with rheumatic disease and a confirmed status of their highest COVID-19 severity level from the COVID-19 Global Rheumatology Alliance (GRA) registry, collected between March 12, 2020, and Aug 27, 2021. Environmental and societal factors were obtained from publicly available sources. The primary endpoint was mortality attributed to COVID-19. We used a multivariable logistic regression to evaluate independent associations between environmental and societal factors and death, after controlling for individual-level risk factors. We used a series of nested mixed-effects models to establish whether environmental and societal factors sufficiently explained country-level variations in death.\n\n14 044 patients from 23 countries were included in the analyses. 10 178 (72\u00b75%) individuals were female and 3866 (27\u00b75%) were male, with a mean age of 54\u00b74 years (SD 15\u00b76). Air pollution (odds ratio 1\u00b710 per 10 \u03bcg/m3 [95% CI 1\u00b701-1\u00b717]; p=0\u00b70105), proportion of the population aged 65 years or older (1\u00b719 per 1% increase [1\u00b710-1\u00b730]; p<0\u00b70001), and population mobility (1\u00b703 per 1% increase in number of visits to grocery and pharmacy stores [1\u00b702-1\u00b705]; p<0\u00b70001 and 1\u00b702 per 1% increase in number of visits to workplaces [1\u00b700-1\u00b703]; p=0\u00b7032) were independently associated with higher odds of mortality. Number of hospital beds (0\u00b794 per 1-unit increase per 1000 people [0\u00b788-1\u00b700]; p=0\u00b7046), human development index (0\u00b765 per 0\u00b71-unit increase [0\u00b744-0\u00b796]; p=0\u00b7032), government response stringency (0\u00b783 per 10-unit increase in containment index [0\u00b774-0\u00b793]; p=0\u00b70018), as well as follow-up time (0\u00b778 per month [0\u00b769-0\u00b788]; p<0\u00b70001) were independently associated with lower odds of mortality. These factors sufficiently explained country-level variations in death attributable to COVID-19 (intraclass correlation coefficient 1\u00b72% [0\u00b71-9\u00b75]; p=0\u00b714).\n\nOur findings highlight the importance of environmental and societal factors as potential explanations of the observed regional disparities in COVID-19 outcomes among people with rheumatic disease and lay foundation for a new research agenda to address these disparities.\n\nAmerican College of Rheumatology and European Alliance of Associations for Rheumatology.", "doi": "10.1016/S2665-9913(22)00192-8", "pmid": "35909441", "labels": {"Type: Journal article": null, "Category: Health": null}, "xrefs": [{"db": "pii", "key": "S2665-9913(22)00192-8"}, {"db": "pmc", "key": "PMC9313519"}], "notes": [], "created": "2022-08-11T12:05:46.825Z", "modified": "2022-08-11T12:05:46.841Z"}