Language
English
Publication Date
11-9-2025
Journal
Children
DOI
10.3390/children12111515
PMID
41300632
PMCID
PMC12650871
PubMedCentral® Posted Date
11-9-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Background/Objectives: Research on the association of adverse social determinants of health (SDOH) with severe pediatric coronavirus disease (COVID-19) is limited. We examined associations between SDOH patterns and COVID-19 severity in children.
Methods: We conducted a prospective, observational study of children (< 18 years) with symptomatic SARS-CoV-2 infection evaluated in an urban pediatric emergency department (March 2021-April 2022) in Detroit, Michigan. Caregivers completed a 34-item survey based on the Healthy People 2030 framework. Severe disease was defined as the occurrence of respiratory/cardiac failure or death within four weeks of diagnosis. Continuous and categorical variables were described using medians and percentages, respectively. Associations between disease severity and risk factors were determined using chi-square tests. Association rule mining was used for feature selection, followed by multivariate logistic regression.
Results: We analyzed data from 354 children [6-12 years: 31.1%, Female: 51.1%, Black: 59%, not Hispanic: 84.7%, public insurance: 77.1%, chronic condition: 27.4%]. Of the total, 113 children had severe disease. Most caregivers were 30-44 years old (53.1%), had less than a college degree (70.4%), and income < USD 50,000 (75.2%). Adverse SDOH reported included food/housing insecurity (24.6%), no support (64.7%), unmet childcare needs (35.9%), and lack of transportation (12.7%). After controlling for age, sex, medical history, income, and obesity, severe disease was associated with caregiver use of drugs/alcohol (OR:5.92, p < 0.001) and social discrimination/lack of support (OR: 1.74, p = 0.030).
Conclusions: Two SDOH patterns (caregiver use of drugs/alcohol and social discrimination/lack of support) were associated with severe COVID-19. Further studies are needed to confirm findings and develop interventions.
Keywords
COVID-19, social determinants of health, disease severity, Emergency Medicine, pediatrics, children, SARS-CoV-2
Published Open-Access
yes
Recommended Citation
Prabhu, Joshua; Acosta, Sebastian; Savorgnan, Fabio; et al., "Social Determinants of Health Patterns in Children with Severe Disease Due to SARS-CoV-2 Infection-An Exploratory Approach" (2025). Faculty and Staff Publications. 5760.
https://digitalcommons.library.tmc.edu/baylor_docs/5760
Included in
Biological Phenomena, Cell Phenomena, and Immunity Commons, Clinical Epidemiology Commons, COVID-19 Commons, Pediatrics Commons