{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:52:32Z","timestamp":1781635952758,"version":"3.54.5"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Socioeconomic deprivation has been consistently associated with worse COVID-19 outcomes, yet it remains unclear whether social gradients persist in populations receiving regular, highly structured, life-sustaining care. Dialysis patients provide a specific context to explore whether structural social determinants continue to shape epidemic vulnerability beyond healthcare access alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the association between socioeconomic deprivation and both COVID-19 infection and clinical severity among dialysis patients in the Provence-Alpes-C\u00f4te d\u2019Azur (PACA) region during the pre-vaccination period (2020).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using the REIN registry including adult dialysis patients living in PACA in 2020. Area-level deprivation was measured using the French Deprivation Index (FDep) at the IRIS level. We analysed factors associated with (i) COVID-19 infection and (ii) severe COVID-19 among infected patients using multivariable models accounting for individual characteristics, comorbidities, dialysis modality, and contextual variables. A sensitivity analysis was performed by epidemic wave to assess robustness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Higher socioeconomic deprivation was associated with increased risk of COVID-19 infection and with more severe clinical forms among infected patients, after adjustment for individual and contextual covariates. Associations were consistent across epidemic waves in sensitivity analyses, supporting the robustness of the findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Social gradients in COVID-19 infection and severity persisted in a population benefiting from regular, continuous dialysis care, suggesting that structural social determinants (e.g. living conditions and deprivation-related vulnerabilities) play a critical role in epidemic risk. Beyond the COVID-19 pandemic, these findings provide lessons for epidemic preparedness and the management of socially vulnerable populations with chronic diseases, supporting the integration of deprivation indicators into routine care and epidemic preparedness strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-026-12774-0","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T06:23:18Z","timestamp":1770704598000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond healthcare access: social deprivation and COVID-19 outcomes in dialysis patients in the provence-alpes-c\u00f4te d\u2019Azur region, France"],"prefix":"10.1186","volume":"26","author":[{"given":"Franck","family":"Mazou\u00e9","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Cortaredona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeline","family":"Cr\u00e9mades","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghizlane","family":"Izaaryene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9n\u00e9dicte","family":"Devictor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Brunet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phanie","family":"Gentile","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"issue":"1","key":"12774_CR1","first-page":"157","volume":"91","author":"D Cucinotta","year":"2020","unstructured":"Cucinotta D, Vanelli M. 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Data were collected and processed in compliance with the European General Data Protection Regulation (GDPR), under the legal basis granted by the French Data Protection Authority (CNIL, authorization number 903,188) and the Advisory Committee on Information Processing for Research (CCTIRS, authorization number 03.149). Verbal informed consent was obtained from all participants at the time of registry inclusion, in accordance with national regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"558"}}