{
  "abstract": "Background Low socioeconomic status (SES) has been associated with increased SARS-CoV-2 infections and COVID-19-related deaths in many settings. Previous systematic reviews are dominated by studies from the US and have not covered later stages of the pandemic. We conducted a UK-focussed systematic review and meta-analysis on the association between SES and COVID-19.Methods Medline, Embase and Web of Science databases were searched for peer-reviewed publications and pre-prints from January 2020 to July 2023 using keyword categories SARS-CoV-2/COVID-19, SES, infection or mortality, and UK. Two reviewers screened studies for inclusion using Covidence and extracted data on measures of association (including odds ratios [OR]). We generated pooled estimates of associations using a random-effects model and conducted subgroup analyses. We used the Newcastle-Ottawa scale to assess study quality.Results We included 103 studies after screening 9,031 records. Fifty-nine studies provided infection outcomes and 53 mortality outcomes. Sixty studies were judged to be good quality, 19 fair and 24 poor. Those living in the 20% most deprived areas (by index of multiple deprivation) had higher SARS-CoV-2 infection risk than those in the 20% least deprived areas (unadjusted OR 1.43 [95% confidence interval 1.24,1.65], number of studies (n)=29). This association remained significant when adjusted for age and sex (age and sex-adjusted OR 1.39[1.15,1.67],n=14). The association between low SES and SARS-CoV-2 infection risk was strongest early in the pandemic, disappearing after December 2021. Mortality was consistently higher among those in the 20% most vs. 20% least deprived areas (unadjusted OR 1.32[1.16,1.51],n=30; age and sex-adjusted OR 2.11[2.01,2.22],n=2) and remained so over all time-periods assessed.Conclusion We found a clear association between low SES and increased SARS-CoV-2 infection and COVID-19-related mortality in the UK over 2020-21. The association with infection, but not mortality, disappeared subsequently. These findings suggest that additional protection from respiratory disease epidemics may be needed for deprived areas.",
  "authors": [
    {
      "affiliations": [
        "MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK",
        "Salisbury NHS Foundation Trust, Salisbury, UK"
      ],
      "name": "Anavi Prakash"
    },
    {
      "affiliations": [
        "MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK",
        "University Hospitals of Leicester NHS Trust, Leicester, UK"
      ],
      "name": "Akshit Goel"
    },
    {
      "affiliations": [
        "The Centre for Health Informatics, Computing, and Statistics, Lancaster University, Lancaster, UK"
      ],
      "name": "Nirali Soni"
    },
    {
      "affiliations": [
        "MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK"
      ],
      "name": "Marie-Claude Boily"
    },
    {
      "affiliations": [
        "MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK",
        "GCU London, Glasgow Caledonian University, London, UK"
      ],
      "name": "Kate Mitchell"
    }
  ],
  "title": "P08-4 The association between socioeconomic status and SARS-CoV-2 infection and COVID-19-related mortality in the UK: a systematic review and meta-analysis",
  "uid": "c4ec4f13-3a90-5e46-958b-3388086bd1c2"
}