Cross-sectional population-based estimates of a rural-urban disparity in prevalence of long COVID among Michigan adults with polymerase chain reaction-confirmed COVID-19, 2020-2022

IF 3.1 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Journal of Rural Health Pub Date : 2023-11-16 DOI:10.1111/jrh.12807

Colleen L. MacCallum-Bridges PhD, MS, Jana L. Hirschtick PhD, MPH, Kristi L. Allgood PhD, MPH, Soomin Ryu PhD, MA, Robert C. Orellana PhD, MPH, Nancy L. Fleischer PhD, MPH

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引用次数: 0

Abstract

Purpose

To (1) assess whether residential rurality/urbanicity was associated with the prevalence of 30- or 90-day long COVID, and (2) evaluate whether differences in long COVID risk factors might explain this potential disparity.

Methods

We used data from the Michigan COVID-19 Recovery Surveillance Study, a population-based probability sample of adults with COVID-19 (n = 4,937). We measured residential rurality/urbanicity using dichotomized Rural-Urban Commuting Area codes (metropolitan, nonmetropolitan). We considered outcomes of 30-day long COVID (illness duration ≥30 days) and 90-day long COVID (illness duration ≥90 days). Using Poisson regression, we estimated unadjusted prevalence ratios (PRs) to compare 30- and 90-day long COVID between metropolitan and nonmetropolitan respondents. Then, we adjusted our model to account for differences between groups in long COVID risk factors (age, sex, acute COVID-19 severity, vaccination status, race and ethnicity, socioeconomic status, health care access, SARS-CoV-2 variant, and pre-existing conditions). We estimated associations for the full study period (Jan 1, 2020-May 31, 2022), the pre-vaccine era (before April 5, 2021), and the vaccine era (after April 5, 2021).

Findings

Compared to metropolitan adults, the prevalence of 30-day long COVID was 15% higher (PR = 1.15 [95% CI: 1.03, 1.29]), and the prevalence of 90-day long COVID was 27% higher (PR = 1.27 [95% CI: 1.09, 1.49]) among nonmetropolitan adults. Adjusting for long COVID risk factors did not reduce disparity estimates in the pre-vaccine era but halved estimates in the vaccine era.

Conclusions

Our findings provide evidence of a rural-urban disparity in long COVID and suggest that the factors contributing to this disparity changed over time as the sociopolitical context of the pandemic evolved and COVID-19 vaccines were introduced.

Abstract Image

查看原文本刊更多论文

2020-2022年密歇根聚合酶链反应确诊COVID-19成人长冠状病毒流行率城乡差异的横断面人口估计

目的:(1)评估居住乡村性/城市化是否与30天或90天的COVID流行率相关，(2)评估长期COVID风险因素的差异是否可以解释这种潜在的差异。方法:我们使用了密歇根COVID-19康复监测研究的数据，这是一项基于人群的COVID-19成人概率样本(n = 4937)。我们使用二元城乡通勤区域代码(大都市和非大都市)来测量居住的乡村/城市性。我们考虑了30天(病程≥30天)和90天(病程≥90天)的结果。使用泊松回归，我们估计了未调整的患病率(pr)，以比较大都市和非大都市受访者之间30天和90天的COVID。然后，我们调整了模型，以考虑各组之间在长COVID风险因素(年龄、性别、COVID-19急性严重程度、疫苗接种状况、种族和民族、社会经济地位、医疗保健可及性、SARS-CoV-2变体和先前存在的疾病)方面的差异。我们估计了整个研究期间(2020年1月1日至2022年5月31日)、疫苗前时期(2021年4月5日之前)和疫苗时期(2021年4月5日之后)的相关性。结果:与大都市成年人相比，非大都市成年人中30天的COVID患病率高15% (PR = 1.15 [95% CI: 1.03, 1.29])， 90天的COVID患病率高27% (PR = 1.27 [95% CI: 1.09, 1.49])。调整长期COVID风险因素并没有减少疫苗前时代的差距估计值，但在疫苗时代将估计值减半。结论:我们的研究结果提供了城乡长期COVID差异的证据，并表明导致这种差异的因素随着大流行的社会政治背景的演变和COVID-19疫苗的引入而随着时间的推移而变化。

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来源期刊

Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

6.10%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Rural Health, a quarterly journal published by the NRHA, offers a variety of original research relevant and important to rural health. Some examples include evaluations, case studies, and analyses related to health status and behavior, as well as to health work force, policy and access issues. Quantitative, qualitative and mixed methods studies are welcome. Highest priority is given to manuscripts that reflect scholarly quality, demonstrate methodological rigor, and emphasize practical implications. The journal also publishes articles with an international rural health perspective, commentaries, book reviews and letters.