ArticleAtencion primaria2026
[Social determinants and COVID-19 mortality: Systematic review of the role of primary care].
Article in Atencion primaria, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo synthesize associations between social determinants and COVID-19 mortality and examine the role of primary care.
designSystematic review registered in PROSPERO (CRD42024502678) and reported according to PRISMA 2020. DATA SOURCES: PubMed/MEDLINE, EMBASE, Web of Science and Scopus, in English, Portuguese, or Spanish. STUDY SELECTION: Observational studies addressing social determinants, COVID-19 mortality, and primary care. DATA EXTRACTION: Country, design, determinants, role of primary care, outcome, and association measures.
resultsOf 259 records, 24 studies were included; 14 were conducted in the US and 13 had an ecological design. In a Spanish cohort, income<€18,000 was associated with higher mortality (aOR 3.29; 95% CI 2.16-5.03), consistent with other studies of deprivation. Across 3141 US counties, the highest social-vulnerability quintile had higher mortality (RR 2.42; 95% CI 2.22-2.64), with a similar direction in other territorial analyses. In Georgia, primary care professional shortage was associated with higher mortality (RR 1.74; 95% CI 1.00-3.00), whereas in Texas greater primary care physician density was associated with lower odds of recording a death (OR 0.93; 95% CI 0.89-0.99). Race/ethnicity-related effects varied by context. Methodological heterogeneity, predominance of ecological designs, and concentration of US studies limit generalizability.
conclusionsCOVID-19 mortality was socially stratified and territorially modulated. Primary care showed associations compatible with a partial mitigating effect but does not replace redistributive and intersectoral policies.
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