ArticleBMJ open2025
Impact of socioeconomic status and country of origin on COVID-19 outcomes in Swedish ICUs: a retrospective registry-based cohort study.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThis study aimed to investigate the impact of socioeconomic status and country of origin on COVID-19 outcomes in Swedish intensive care units (ICUs), hypothesising that these factors are independently associated with 90-day mortality.
designRegistry-based cohort study.
settingSwedish ICUs, from 6 March 2020 to 31 December 2022.
participantsAdults (≥18 years) with confirmed SARS-CoV-2 infection and acute hypoxaemic respiratory failure. A total of 5833 patients were included in the multivariable model.
interventionsNot applicable. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was 90-day mortality. Secondary outcomes included 1-year mortality and ventilator and renal replacement therapy-free days within 60 days post-ICU admission.
resultsNon-European country of origin was independently associated with higher 90-day and 1-year mortality adjusted OR (aOR) 1.34 [95% CI 1.13 to 1.61], p=0.001, aOR 1.26 [95% CI 1.01 to 1.5], p=0.01, respectively. Socioeconomic variables did not significantly impact mortality or organ support-free days. Other predictors of 90-day mortality included age, sex, chronic heart and lung disease, Simplified Acute Physiology Score 3 score, immunosuppression, time in hospital prior to ICU admission, pandemic wave and admission Partial pressure of oxygen in arterial blood/Fraction of inspired oxygen-ratio.
conclusionsThe study identified significant disparities in COVID-19 outcomes based on country of origin, with non-European patients facing higher mortality risks. These findings could challenge the notion of equitable healthcare in Sweden and underscore the need for further research into systemic inequalities.
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