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Risk factors for SARS-CoV-2 infection: a test-negative case-control study with additional population controls in

Marjut Sarjomaa1,2, Chi Zhang3,4, Yngvar Tveten5

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|January 8, 2024
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Summary

This study identified risk factors for SARS-CoV-2 infection using a combined test-negative design and population controls. Smoking was a significant negative risk factor for COVID-19 in both analyses.

Keywords:
COVID-19SARS-CoV-2 infectioncase-control studiesrisk factors

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Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Public Health

Background:

  • Understanding risk factors for SARS-CoV-2 infection is crucial for public health interventions.
  • Previous studies have used various designs, but combining approaches offers a more comprehensive view.

Purpose of the Study:

  • To assess risk factors for SARS-CoV-2 infection using a combined test-negative design (TND) and population controls.
  • To compare the associations of risk factors between PCR-positive cases and controls using different study designs.

Main Methods:

  • A multicentre case-control study with a test-negative design and additional population controls in South-Eastern Norway.
  • Adults tested for SARS-CoV-2 via PCR between February and December 2020 were included.
  • Self-reported questionnaire data were used to assess risk factors.

Main Results:

  • Male sex was associated with SARS-CoV-2 risk in the TND but not with population controls.
  • Smoking showed a negative association with SARS-CoV-2 infection in both analyses.
  • Factors like asthma, wood heating, and hypertension showed varied associations depending on the control group used.

Conclusions:

  • Combining TND with population controls provides a robust method for identifying SARS-CoV-2 risk factors.
  • Smoking is a consistent negative risk factor for COVID-19.
  • The choice of control group significantly influences the identification of certain risk factors.