{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:43:23Z","timestamp":1777859003235,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"University of Georgia College of Pharmacy Morgan Fund"},{"name":"Randy Ellison Community Pharmacy Fund"},{"name":"National for Center Advancing Translational Sciences of the National Institutes of Health","award":["UL1TR002378"],"award-info":[{"award-number":["UL1TR002378"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Disparities in COVID-19 infection, illness severity, hospitalization, and death are often attributed to age and comorbidities, which fails to recognize the contribution of social, environmental, and financial factors on health. The purpose of this study was to examine relationships between social determinants of health (SDOH) and COVID-19 severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This multicenter retrospective study included adult patients hospitalized with COVID-19 in Southwest Georgia, U.S. The primary outcome was the severity of illness among patients on hospital admission for COVID-19. To characterize the effect of biological and genetic factors combined with SDOH on COVID-19, we used a multilevel analysis to examine patient-level and ZIP code-level data to determine the risk of COVID-19 illness severity at admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 392 patients included, 65% presented with moderate or severe COVID-19 compared to 35% with critical disease. Compared to moderate or severe COVID-19, increasing levels of Charlson Comorbidity Index (OR 1.15, 95% CI 1.07-1.24), tobacco use (OR 1.85, 95% CI 1.10-3.11), and unemployment or retired versus employed (OR 1.91, 95% CI 1.04-3.50 and OR 2.17, 95% CI 1.17-4.02, respectively) were associated with increased odds of critical COVID-19 in bivariate models. In the multi-level model, ZIP codes with a higher percentage of Black or African American residents (OR 0.94, 95% CI 0.91-0.97) were associated with decreased odds of critical COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Differences in SDOH did not lead to significantly higher odds of presenting with severe COVID-19 when accounting for patient-level and ZIP code-level variables.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319221092244","type":"journal-article","created":{"date-parts":[[2022,4,15]],"date-time":"2022-04-15T07:15:43Z","timestamp":1650006943000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Severity on Hospital Admission for COVID-19: An Analysis of Social Determinants of Health From an Early Hot Spot in the Southeastern U.S."],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4018-0195","authenticated-orcid":false,"given":"Daniel B.","family":"Chastain","sequence":"first","affiliation":[{"name":"University of Georgia College of Pharmacy, Albany, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2439-5241","authenticated-orcid":false,"given":"Sharmon P.","family":"Osae","sequence":"additional","affiliation":[{"name":"University of Georgia College of Pharmacy, Albany, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geren M.","family":"Thomas","sequence":"additional","affiliation":[{"name":"John D. Archbold Memorial Hospital, Thomasville, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley M.","family":"Burt","sequence":"additional","affiliation":[{"name":"Colquitt Regional Medical Center, Moultrie, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Rao","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Aurora, CO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9s F.","family":"Henao-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"University of Colorado, Anschutz Medical Campus, Aurora, CO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Franco-Paredes","sequence":"additional","affiliation":[{"name":"University of Colorado, Anschutz Medical Campus, Aurora, CO, USA"},{"name":"Hospital Infantil de M\u00e9xico, Federico G\u00f3mez, M\u00e9xico City, M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L.","family":"Waller","sequence":"additional","affiliation":[{"name":"Augusta University, Augusta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry N.","family":"Young","sequence":"additional","affiliation":[{"name":"University of Georgia College of Pharmacy, Athens, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,4,15]]},"reference":[{"key":"bibr1-21501319221092244","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00028-20"},{"key":"bibr2-21501319221092244","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1966"},{"key":"bibr3-21501319221092244","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.26186.1"},{"key":"bibr4-21501319221092244","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-020-00833-4"},{"key":"bibr5-21501319221092244","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjms.2020.06.015"},{"key":"bibr6-21501319221092244","doi-asserted-by":"publisher","DOI":"10.7326\/M20-6306"},{"key":"bibr7-21501319221092244","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2020.06.004"},{"key":"bibr8-21501319221092244","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202006-583RL"},{"key":"bibr9-21501319221092244","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2020.00598"},{"key":"bibr10-21501319221092244","unstructured":"HHS. 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