{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T21:34:20Z","timestamp":1764884060014,"version":"3.46.0"},"reference-count":21,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"unspecified","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016670","name":"Region \u00d6sterg\u00f6tland","doi-asserted-by":"publisher","award":["ALF Grants"],"award-info":[{"award-number":["ALF Grants"]}],"id":[{"id":"10.13039\/100016670","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Link\u00f6ping Society of Medicine, Link\u00f6ping, Sweden"},{"name":"The Academy for Health and Welfare, Region J\u00f6nk\u00f6ping, Sweden"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,27]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to investigate the impact of socioeconomic status and country of origin on COVID-19 outcomes in Swedish intensive care units (ICUs), hypothesising that these factors are independently associated with 90-day mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Registry-based cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Swedish ICUs, from 6 March 2020 to 31 December 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults (\u226518 years) with confirmed SARS-CoV-2 infection and acute hypoxaemic respiratory failure. A total of 5833 patients were included in the multivariable model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was 90-day mortality. Secondary outcomes included 1-year mortality and ventilator and renal replacement therapy-free days within 60 days post-ICU admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Non-European country of origin was independently associated with higher 90-day and 1-year mortality adjusted OR (aOR) 1.34 [95% CI 1.13 to 1.61], p=0.001, aOR 1.26 [95% CI 1.01 to 1.5], p=0.01, respectively. Socioeconomic variables did not significantly impact mortality or organ support-free days. Other predictors of 90-day mortality included age, sex, chronic heart and lung disease, Simplified Acute Physiology Score 3 score, immunosuppression, time in hospital prior to ICU admission, pandemic wave and admission Partial pressure of oxygen in arterial blood\/Fraction of inspired oxygen-ratio.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study identified significant disparities in COVID-19 outcomes based on country of origin, with non-European patients facing higher mortality risks. These findings could challenge the notion of equitable healthcare in Sweden and underscore the need for further research into systemic inequalities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-099763","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T05:40:13Z","timestamp":1763358013000},"page":"e099763","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of socioeconomic status and country of origin on COVID-19 outcomes in Swedish ICUs: a retrospective registry-based cohort study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8711-9044","authenticated-orcid":false,"given":"Knut","family":"Taxbro","sequence":"first","affiliation":[{"name":"Biomedical and Clinical Sciences, Linkoping university, Link\u00f6ping, Sweden"},{"name":"Anaesthesia and Intensive Care Medicine, Ryhov County Hospital, J\u00f6nk\u00f6ping, Sweden"},{"name":"Helicopter Emergency Medical Service, Region V\u00e4stra G\u00f6taland, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasmus","family":"\u00c5hman","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences, Link\u00f6ping University, Link\u00f6ping, Sweden"},{"name":"R\u00e5sl\u00e4tt Primary Health Care Centre, J\u00f6nk\u00f6ping, Region J\u00f6nk\u00f6ping County, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle S","family":"Chew","sequence":"additional","affiliation":[{"name":"Biomedical and Clinical Sciences, Linkoping university, Link\u00f6ping, Sweden"},{"name":"Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Engerstr\u00f6m","sequence":"additional","affiliation":[{"name":"Biomedical and Clinical Sciences, Linkoping university, Link\u00f6ping, Sweden"},{"name":"Anaesthesia and Intensive Care Medicine, Vrinnevi Hospital in Norrk\u00f6ping, Norrk\u00f6ping, Sweden"},{"name":"Cardiothoracic and Vascular Surgery and Anaesthesia, Link\u00f6ping University Hospital, Link\u00f6ping, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,16]]},"reference":[{"key":"2025120413273518000_15.11.e099763.1","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2023.101877","article-title":"Ethnic inequalities in COVID-19 infection, hospitalisation, intensive care admission, and death: a global systematic review and meta-analysis of over 200 million study participants","volume":"57","author":"Irizar","year":"2023","journal-title":"EClinicalMedicine"},{"key":"2025120413273518000_15.11.e099763.2","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2021-218278"},{"key":"2025120413273518000_15.11.e099763.3","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-022-15884-2","article-title":"Immigrant background and socioeconomic status are associated with severe COVID-19 requiring intensive care","volume":"12","author":"Nordberg","year":"2022","journal-title":"Sci Rep"},{"key":"2025120413273518000_15.11.e099763.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"2025120413273518000_15.11.e099763.5","unstructured":"United Nations Statistics Division . 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