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Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK)
Hayley Holt1, Mohammad Talaei1, Matthew Greenig1
1Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Insights
Asian/Asian British ethnicity and raised body mass index (BMI) increase COVID-19 odds, while atopic disease decreases them. These findings clarify susceptibility factors beyond severe disease risk.
Area of Science:
- Epidemiology
- Infectious Disease Research
- Public Health
Background:
- Known risk factors for severe COVID-19 include older age, male sex, obesity, certain ethnicities, and pre-existing medical conditions.
- The influence of these factors on initial susceptibility to developing COVID-19 remains uncertain.
- Understanding susceptibility factors is crucial for targeted prevention strategies.
Purpose of the Study:
- To investigate potential risk factors associated with the odds of developing COVID-19.
- To differentiate between risk factors for susceptibility and those for disease severity.
- To provide evidence-based insights into COVID-19 transmission dynamics.
Main Methods:
- Prospective, population-based cohort study (COVIDENCE UK) conducted from May 2020 to February 2021.
- Baseline and monthly follow-up questionnaires collected data on potential risk factors and incident COVID-19 cases.
- Logistic regression models were used to calculate multivariable-adjusted odds ratios (aORs) for identified associations.
Main Results:
- Asian/Asian British ethnicity (aOR 2.28) and raised body mass index (BMI) (aOR 1.50 for BMI 25.0-30.0; aOR 1.39 for BMI >30.0) were independently associated with increased odds of developing COVID-19.
- Household overcrowding, social contact frequency, indoor public place visits, and frontline occupations also increased COVID-19 odds.
- Atopic disease showed an independent association with decreased odds of developing COVID-19 (aOR 0.75).
Conclusions:
- After adjusting for exposure factors, specific ethnicities (Asian/Asian British) and raised BMI are linked to higher COVID-19 susceptibility.
- Atopic disease appears to be a protective factor against developing COVID-19.
- Age, sex, and other medical conditions did not show independent associations with COVID-19 susceptibility in this cohort.
Background:
Risk factors for severe COVID-19 include older age, male sex, obesity, black or Asian ethnicity and underlying medical conditions. Whether these factors also influence susceptibility to developing COVID-19 is uncertain.
Methods:
We undertook a prospective, population-based cohort study (COVIDENCE UK) from 1 May 2020 to 5 February 2021. Baseline information on potential risk factors was captured by an online questionnaire. Monthly follow-up questionnaires captured incident COVID-19. We used logistic regression models to estimate multivariable-adjusted ORs (aORs) for associations between potential risk factors and odds of COVID-19.
Results:
We recorded 446 incident cases of COVID-19 in 15 227 participants (2.9%). Increased odds of developing COVID-19 were independently associated with Asian/Asian British versus white ethnicity (aOR 2.28, 95% CI 1.33 to 3.91), household overcrowding (aOR per additional 0.5 people/bedroom 1.26, 1.11 to 1.43), any versus no visits to/from other households in previous week (aOR 1.31, 1.06 to 1.62), number of visits to indoor public places (aOR per extra visit per week 1.05, 1.02 to 1.09), frontline occupation excluding health/social care versus no frontline occupation (aOR 1.49, 1.12 to 1.98) and raised body mass index (BMI) (aOR 1.50 (1.19 to 1.89) for BMI 25.0-30.0 kg/m2 and 1.39 (1.06 to 1.84) for BMI >30.0 kg/m2 versus BMI <25.0 kg/m2). Atopic disease was independently associated with decreased odds (aOR 0.75, 0.59 to 0.97). No independent associations were seen for age, sex, other medical conditions, diet or micronutrient supplement use.
Conclusions:
After rigorous adjustment for factors influencing exposure to SARS-CoV-2, Asian/Asian British ethnicity and raised BMI were associated with increased odds of developing COVID-19, while atopic disease was associated with decreased odds.
Trial Registration Number:
ClinicalTrials.gov Registry (NCT04330599).
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