Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 51 11 2022 11 09 2458 2471 Yang-Jie Zhu Department of Military Health Management, College of Health Service, Naval Medical University, Shanghai 200433, China Kang Tang Department of Military Health Management, College of Health Service, Naval Medical University, Shanghai 200433, China Fang-Jie Zhao Department of Military Health Management, College of Health Service, Naval Medical University, Shanghai 200433, China Bo-Yang Yu 1. Department of Military Health Management, College of Health Service, Naval Medical University, Shanghai 200433, China 2. Department of Medical Health Service, General Hospital of Northern Theater Command of PLA, Shenyang 110016, China Tong-Tong Liu 1. Department of Military Health Management, College of Health Service, Naval Medical University, Shanghai 200433, China 2. Department of Medical Health Service, 969th Hospital of PLA Joint Logistics Support Forces, Hohhot 010051, China Lu-Lu Zhang Department of Military Health Management, College of Health Service, Naval Medical University, Shanghai 200433, China 2022 07 24 2022 09 18 Background: The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected socially disadvantaged groups; however, the association between socioeconomic status and healthcare utilization among COVID-19 patients remains unclear. Therefore, a systematic review and meta-analysis was conducted to assess the association between socioeconomic status and hospitalization and intensive care unit admission among COVID-19 patients. Methods: PubMed, Embase, and the Cochrane Register of Controlled Trials were searched for relevant literature (updated to Jun 2022). Studies that investigated the association of social deprivation with hospitalization and intensive care unit admission in COVID-19 patients were included. The primary outcomes included risk of hospitalization and intensive care unit admission, measured by odds ratio. Results: Eleven studies covering 2,423,095 patients were included in the meta-analysis. Socially disadvantaged patients had higher odds of hospitalization in comparison to socially advantaged patients (odds ratio 1.25, 95% confidence interval: 1.14 to 1.38; P<0.01). The odds of intensive care unit admission among more deprived patients was not significantly different from that of less deprived patients (odds ratio 1.03, 95% confidence interval: 0.78 to 1.35; P=0.85). These findings were proven robust through subgroup and sensitivity analyses. Conclusion: Socially disadvantaged populations have higher odds of hospitalization if they become infected with COVID-19. More effective medical support and interventions for these vulnerable populations are required to reduce inequity in healthcare utilization and alleviate the burden on healthcare systems.   https://ijph.tums.ac.ir/index.php/ijph/article/view/29392 https://ijph.tums.ac.ir/index.php/ijph/article/download/29392/7771