Evidence map›Paper›PMID 39676287›Full record

ArticleJournal of public health (Oxford, England)2025

A syndemic approach to the study of Covid-19-related death: a cohort study using UK Biobank data.

Daniela Fonseca de Freitas, Kamaldeep Bhui, Christophe Clesse, Uzma Zahid, Roisin Mooney, Easter Joury, Richard D Hayes, Mizanur Khondoker

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PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of public health (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Daniela Fonseca de FreitasCHiMES Collaborative, Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK.ORCID 0000-0002-8876-4595
Kamaldeep BhuiCHiMES Collaborative, Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK.ORCID 0000-0002-9205-2144
Christophe ClesseCentre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.ORCID 0000-0003-3042-0770
Uzma ZahidCHiMES Collaborative, Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK.ORCID 0000-0002-7849-4907
Roisin MooneyCHiMES Collaborative, Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK.ORCID 0000-0001-5792-3314
Easter JouryDental Public Health, Faculty of Medicine and Dentistry, Queen Mary University of London and Barts Health National Health Service Trust, London, UK.ORCID 0000-0002-2983-0679
Richard D HayesDepartment of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID 0000-0003-4453-244X
Mizanur KhondokerNorwich Medical School, University of East Anglia, Norwich, UK.ORCID 0000-0002-1801-1635

Funding

Lankelly Chase FoundationMaudsley Biomedical Research CentreNational Institute for Health and Care ResearchNIHR Maudsley Biomedical Research Centre at South London and Maudsley National Health Service Foundation TrustSynergi Collaborative Centre
6 · The paper itself

Abstract

backgroundThe Covid-19 pandemic showed higher infection, severity and death rates among those living in poorer socioeconomic conditions. We use syndemic theory to guide the analyses to investigate the impact of social adversity and multiple long-term conditions (MLTC) on Covid-19 mortality.

methodsThe study sample comprised 154 725 UK Biobank participants. Structural equation modeling was used to investigate pathways between traumatic events, economic deprivation, unhealthy behaviors, MLTC, for Covid-19 mortality. Cox regression analysis was used to investigate MLTC and Covid-19 mortality. We also tested effect modification by traumatic events, economic deprivation and unhealthy behaviors.

resultsCovid-19 mortality (n = 186) was directly explained by overall level of MLTC. Economic deprivation and unhealthy behaviors contributed to Covid-19 death indirectly via their negative impact on MLTC. The risk for Covid-19 mortality grew exponentially for every quintile of predicted scores of MLTC. The presence of traumatic events, economic deprivation or unhealthy behaviors did not modify the impact of MLTC on Covid-19 mortality.

conclusionsResults suggest a serially causal pathway between economic deprivation and unhealthy behaviors leading to MLTC, which increased the risk of Covid-19 mortality. Policies to tackle the social determinants of health and to mitigate the negative impact of multimorbidity are needed.

Indexed as

COVID-19SyndemicAdultAgedBiological Specimen BanksCohort StudiesFemaleHumansMaleMiddle AgedRisk FactorsSARS-CoV-2Socioeconomic FactorsUK BiobankUnited KingdomCovid-19epidemicsethnic minorityhealthcare disparitiesmortalitymultimorbiditypublic healthsyndemics

Identifiers

PMID39676287
PMCPMC11879006

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.