Deprivation effects on length of stay and death of hospitalised COVID-19 patients in Greater Manchester.

Introduction: The World Health Organisation declared a global pandemic in March 2020. The impact of COVID-19 has not been felt equally by all regions and sections of society. The extent to which socio-demographic and deprivation factors have adversely impacted on outcomes is of concern to those looking to 'level-up' and decrease widening health inequalities.

Objectives: In this paper we investigate the impact of deprivation on the outcomes for hospitalised COVID-19 patients in Greater Manchester during the first wave of the pandemic in the UK (30/12/19-2/1/21), controlling for proven risk factors from elsewhere in the literature.

Methods: We fitted Negative Binomial and logistic regression models to NHS administrative data to investigate death from COVID in hospital and length of stay for surviving patients in a sample of adult patients admitted within Greater Manchester (N = 10,372, spell admission start dates from 30/12/2019 to 02/01/2021 inclusive).

Results: Deprivation was associated with death risk for hospitalised patients but not with length of stay. Male sex, co-morbidities and older age was associated with higher death risk. Male sex and co-morbidities were associated with increased length of stay. Black and other ethnicities stayed longer in hospital than White and Asian patients. Period effects were detected in both models with death risk reducing over time, but the length of stay increasing.

Conclusion: Deprivation is important for death risk; however, the picture is complex, and the results of this analysis suggest that the reported COVID related mortality and deprivation linked reductions in life expectancy, may have occurred in the community, rather than in acute settings.

Highlights: Older age and male sex are predictive of longer hospital stays and higher death risk for hospitalised cases in this analysis.Deprivation is associated with death risk but not length of stay for hospitalised patients.Ethnicity is associated with length of stay, but not with death risk.There is a social gradient in health, but these data would suggest that once in the care of an NHS hospital in an acute health episode, outcomes are more equal.