P08-4 The association between socioeconomic status and SARS-CoV-2 infection and COVID-19-related mortality in the UK: a systematic review and meta-analysis

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Background Low socioeconomic status (SES) has been associated with increased SARS-CoV-2 infections and COVID-19-related deaths in many settings. Previous systematic reviews are dominated by studies from the US and have not covered later stages of the pandemic. We conducted a UK-focussed systematic review and meta-analysis on the association between SES and COVID-19. Methods Medline, Embase and Web of Science databases were searched for peer-reviewed publications and pre-prints from January 2020 to July 2023 using keyword categories SARS-CoV-2/COVID-19, SES, infection or mortality, and UK. Two reviewers screened studies for inclusion using Covidence and extracted data on measures of association (including odds ratios [OR]). We generated pooled estimates of associations using a random-effects model and conducted subgroup analyses. We used the Newcastle-Ottawa scale to assess study quality. Results We included 103 studies after screening 9,031 records. Fifty-nine studies provided infection outcomes and 53 mortality outcomes. Sixty studies were judged to be good quality, 19 fair and 24 poor. Those living in the 20% most deprived areas (by index of multiple deprivation) had higher SARS-CoV-2 infection risk than those in the 20% least deprived areas (unadjusted OR 1.43 [95% confidence interval 1.24,1.65], number of studies (n)=29). This association remained significant when adjusted for age and sex (age and sex-adjusted OR 1.39[1.15,1.67],n=14). The association between low SES and SARS-CoV-2 infection risk was strongest early in the pandemic, disappearing after December 2021. Mortality was consistently higher among those in the 20% most vs. 20% least deprived areas (unadjusted OR 1.32[1.16,1.51],n=30; age and sex-adjusted OR 2.11[2.01,2.22],n=2) and remained so over all time-periods assessed. Conclusion We found a clear association between low SES and increased SARS-CoV-2 infection and COVID-19-related mortality in the UK over 2020-21. The association with infection, but not mortality, disappeared subsequently. These findings suggest that additional protection from respiratory disease epidemics may be needed for deprived areas.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.