Social determinants of health exacerbate disparities in COVID-19 illness severity and lasting symptom complaints

BACKGROUND: Increasing reports of long-term symptoms following COVID-19 infection, even among mild cases, necessitates systematic investigation into the prevalence and type of lasting illness. Notably, there is limited data regarding the influence of social determinants of health, like perceived discrimination and economic stress, which may exacerbate COVID-19 health risks. The primary goals of this study are to test the bearing of subjective experiences of discrimination, financial security, and quality of care on illness severity and lasting symptom complaints. METHODS: 1,584 recovered COVID-19 patients that experienced mild to severe forms of the disease provided information about their illness, medical history, lasting symptoms, and psychosocial information. Prevalence data isolated differences in patients infected early versus late in the pandemic. Path analyses examined hypothesized associations between discrimination, illness severity, and lasting symptoms. Post hoc logistic regressions tested social determinants hypothesized to predict neurological, cognitive, or mood symptoms. RESULTS: 70.6% of patients reported presence of one or more lasting symptoms after recovery. Neural systems were especially impacted, and 19.4% and 25.1% of patients reported mood or cognitive/memory complaints, respectively. Path models demonstrated that frequency and stress about experiences of discrimination predicted increased illness severity and increased lasting symptom count, even when adjusting for sociodemographic factors and mental/physical health comorbidities. Notably, this effect was specific to stress related to discrimination, and did not extend to general stress levels. Further, perceived but not objective socioeconomic status (SES) was associated with increased lasting symptom complaints after recovery. Finally, associations between discrimination and illness differed with individual perceptions about quality of medical care. CONCLUSIONS: Lasting symptoms after recovery from COVID-19 are highly prevalent and neural systems are significantly impacted. Importantly, psychosocial factors (perceived discrimination and perceived SES) can exacerbate individual health risk. This study provides actionable directions for improved health outcomes by establishing that sociodemographic risk and medical care influence near and long-ranging health outcomes.

Symptom complaints and impact on functioning in youth with hypermobile Ehlers–Danlos syndrome

Hypermobile Ehlers–Danlos syndrome (hEDS), a genetic connective tissue disorder, involves several body systems which makes symptom management and functioning difficult. The aim of this study was to understand pediatric hEDS patients’ symptoms and primary complaints. Additionally, we examined the cumulative impact of symptoms on physical and psychological functioning. Thirty-four youth with hEDS were recruited from a genetics clinic and reported the hardest thing about having hEDS, their pain, fatigue, physical symptoms, functional disability, anxiety, and depression. Physical symptoms (pain and fatigue) and limitations (keeping up with friends) were reported as the most difficult parts of having hEDS. A higher number of somatic symptoms was the strongest predictor of disability, anxiety, and depression. Physical symptoms are subjectively distressing and significantly related to impairments in physical and psychological functioning. Thus, addressing these varied symptoms in treatment may yield better functioning in youth with hEDS.

Health Consequences Of Benzene Exposure Among Children Following a Flaring Incident At Petroleum Refinery In Texas City

Objective Human exposure to benzene is associated with multiple adverse health effects leading to hematological malignancies. The objective of this retrospective study was to evaluate the health consequences of benzene and other toxic chemical exposure in children following a flaring incident at the British petroleum refinery in the Texas City, Texas. Methods The study included children aged < 17 years who had been exposed and unexposed to benzene due to a flaring incident at the British petroleum refinery facility. Using medical charts, clinical data including white blood cell (WBC) counts, platelets counts, hemoglobin, hematocrit, blood urea nitrogen (BUN,) creatinine, alkaline phosphatase (ALP), aspartate amino transferase (AST), alanine amino transferase (ALT), and somatic symptom complaints by the children exposed to benzene were reviewed and analyzed. Results A total of 312 subjects (benzene exposed, n=157 and unexposed, n=155) were included. Hematologic analysis showed that WBC counts were significantly decreased in benzene exposed children compared with the unexposed children (6.8 ± 2.1 versus 7.3 ± 1.7, P=0.022). Conversely, platelet (X 103 per µL) counts were increased significantly in the benzene exposed group compared with the unexposed group (278.4 ± 59.9 versus 261.6 ± 51.7, P=0.005). Similarly, benzene exposed children had significantly higher levels of ALP (183.7± 95.6 versus 165 ± 70.3 IU/L, P=0.04), AST (23.6 ± 15.3versus 20.5 ± 5.5 IU/L, P = 0.015), and ALT (19.2 ± 7.8 versus 16.9 ± 6.9 IU/L, P=0.005) compared with the unexposed children. Conclusion Together, the results of the study reveal that children exposed to benzene experienced significantly altered blood profiles, liver enzymes and somatic symptoms indicating that children exposed to benzene are at a higher risk of developing hepatic or blood related disorders. Disclosures: No relevant conflicts of interest to declare.