Socioeconomic Disparities in Health

ABC

Letter to the Editor

Predictors of Atrial Arrhythmia Recurrence after Catheter Ablation: Socioeconomic Impact in Low to Middle-Income Countries

Marwan Shawki et al. Thalys Sampaio Rodrigues Levindo Jose Garcia Quarto

To the Editor,

We read with great interest the article by Ternes et al., recently published in the Arquivos Brasileiros de Cardiologia, with its accompanying insightful editorial.^, This multicentre prospective cohort study of consecutive patients across three centres in Brazil provided valuable insights into the predictors of atrial arrhythmia recurrence following first-time catheter ablation. It highlighted its clinical setting in a middle-income country and reported outcomes similar to those in high-income countries. However, the results must be interpreted cautiously, and some points merit further discussion.

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IJCS

Original Article

A Geoprocessing Approach for Mortality and Social Vulnerability Analysis during the COVID-19 Pandemic

Andres Felipe Valencia Rendon et al. Isabela Mendes Volschan Manoella Novais Pereira Wagner Lima Monteiro … Alessandra de Freitas Pimentel Emilia Matos do Nascimento Basilio de Bragança Pereira Glaucia Maria Moraes de Oliveira

Abstract

Background

Brazil had high COVID-19 lethality/mortality with multiple social inequalities, where color/race was highly relevant, especially in Rio de Janeiro. Therefore, we hypothesize that COVID-19 hospitalized patients with a highly socially vulnerable background would have more significant in-hospital mortality.

Objective

To analyze the socioeconomic factors of social vulnerability and their association with COVID-19 mortality.

Methods

This work was a prospective study of 274 confirmed adult COVID-19 hospitalized patients in the University Hospital of Clementino Fraga Filho (HUCFF). The clinical features/blood chemistry information were collected from the clinical record. The ArcGIS Pro Software (Esri Gis mapping software, Redlands California-US) and a Python-based algorithm were used to determine in-app/in-map variable management relevance to the socioeconomic variables, inequity markers, and vulnerability. Our study also analyzed the transfers from other primary care institutions to our hospital in order to examine its potential delays in advanced medical care. Logistic regression and ROC curve were used to investigate in-hospital mortality for our statistical analysis. The significance level adopted in the statistical analysis was 5% Results: Male sex, total days of hospitalization, age, having more than three comorbidities, intensive care unit (ICU) admission, hemodialysis, and transfer from other hospitals showed statistical significance. Patients living in low-adequate households (p = 0.030) with high in-house individual agglomeration markers (p = 0.017) and transfers from another Primary Health Care (PHC) institution (p = 0.047) were associated with increased in-hospital mortality, with high ICU admission and mechanical ventilation.

Conclusions

In-hospital mortality due to COVID-19 was influenced by social individual background characteristics of vulnerability. Among other clinical parameters, these markers should be considered to predict the likelihood of complications related to the COVID-19 pandemic.