Patient Income Does Not Predict Disability or Mortality in Hospitalized COVID-19 Patients in a Large Health Care System in the Chicago Metropolitan Area

Abstract

Race, income, and their role in COVID-19 infection in the community have been extensively reported, but their impact on outcomes in hospitalized patients is less well defined. We retrospectively analyzed the first 509 COVID-19 patients in our hospital network, examining associations between median household income, 30-day mortality, and ambulatory state at discharge (using the modified Rankin scale (mRS)), adjusting for hospitalization at the academic medical center (AMC) and other variables. Income did not predict mortality. Higher income was associated with slightly increased odds of ability to ambulate at discharge only when accounting for hospital type. At the AMC, income and mortality were lower and functional outcomes more favorable. Patients with lower incomes had greater comorbidity burden. That income was not associated with measures of morbidity and mortality from COVID-19 is a remarkable and encouraging finding. Academic medical centers may mitigate detrimental effects of socioeconomic disparities on COVID-19 seen at the community level.

Household income is associated with functional outcomes in a multi-institutional cohort of patients with ischemic stroke and COVID-19

“…A study from the state of Michigan, USA found that patients hospitalized with COVID-19 coming from socially vulnerable neighborhoods had greater illness severity on presentation, requiring more intensive treatments, but after hospitalization, patients had no difference in mortality or discharge disposition 4 . Similar results were found in the largest Chicago-based health care system, where median household income was not associated with measures of morbidity and mortality in hospitalized patients with COVID-19 5 .…”

“…The patients included in this study were all treated at academic hospitals in Chicago, and previous findings using a cohort of COVID-19 patients recruited at academic hospitals showed protection against income-related outcomes 4 , 5 . However, if hospital systems and rehabilitation services were already stretched beyond normal capacity due to COVID-19, patients suffering from both stroke and COVID-19 may have had fewer stroke-specific resources such as physical therapy and occupational therapy available during hospitalization 41 , 42 .…”