Politi, JulietaMartín Sánchez, MarioMercuriali, LilasBorras Bermejo, BlancaLópez Contreras, JoaquínVilella, AnnaVillar García, JuditCOVID-19 Surveillance Working Group of BarcelonaOrcau, ÀngelsGarcía de Olalla, PatríciaRius, Cristina2021-09-142021-09-142021Politi J, Martín-Sánchez M, Mercuriali L, Borras-Bermejo B, Lopez-Contreras J, Vilella A, Villar J; COVID-19 Surveillance Working Group of Barcelona, Orcau A, de Olalla PG, Rius C. Epidemiological characteristics and outcomes of COVID-19 cases: mortality inequalities by socio-economic status, Barcelona, Spain, 24 February to 4 May 2020. Euro Surveill. 2021;26(20):2001138. DOI: 10.2807/1560-7917.ES.2021.26.20.20011381025-496Xhttp://hdl.handle.net/10230/48445Background: Population-based studies characterising outcomes of COVID-19 in European settings are limited, and effects of socio-economic status (SES) on outcomes have not been widely investigated. Aim: We describe the epidemiological characteristics of COVID-19 cases, highlighting incidence and mortality rate differences across SES during the first wave in Barcelona, Catalonia, Spain. Methods: This population-based study reports individual-level data of laboratory-confirmed COVID-19 cases diagnosed from 24 February to 4 May 2020, notified to the Public Health Agency of Barcelona and followed until 15 June 2020. We analysed end-of-study vital status and the effects of chronic conditions on mortality using logistic regression. Geocoded addresses were linked to basic health area SES data, estimated using the composed socio-economic index. We estimated age-standardised incidence, hospitalisation, and mortality rates by SES. Results: Of 15,554 COVID-19-confirmed cases, the majority were women (n = 9,028; 58%), median age was 63 years (interquartile range: 46–83), 8,046 (54%) required hospitalisation, and 2,287 (15%) cases died. Prevalence of chronic conditions varied across SES, and multiple chronic conditions increased risk of death (≥ 3, adjusted odds ratio: 2.3). Age-standardised rates (incidence, hospitalisation, mortality) were highest in the most deprived SES quartile (incidence: 1,011 (95% confidence interval (CI): 975–1,047); hospitalisation: 619 (95% CI: 591–648); mortality: 150 (95% CI: 136–165)) and lowest in the most affluent (incidence: 784 (95% CI: 759–809); hospitalisation: 400 (95% CI: 382–418); mortality: 121 (95% CI: 112–131)). Conclusions: COVID-19 outcomes varied markedly across SES, underscoring the need to implement effective preventive strategies for vulnerable populations.application/pdfengThis article is copyright of the authors or their affiliated institutions, 2021. This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence and indicate if changes were made.info:eu-repo/semantics/articlehttp://dx.doi.org/10.2807/1560-7917.ES.2021.26.20.2001138SARS-CoV-2EpidemiologyHealth inequalitiesMortalitySocio-economic statusSurveillanceinfo:eu-repo/semantics/openAccess