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Published on: August 8, 2019
Association of Chronotype and Shiftwork With COVID-19 Infection
Stuart F Quan1, Matthew D Weaver, Mark É Czeisler
1From the Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, Massachusetts (S.F.Q., M.D.W., L.K.B., R.I.L., R.R., S.M.W.R., C.A.C.); Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts (S.F.Q., M.D.W., L.K.B., R.R., S.M.W.R., C.A.C.); Francis Weld Peabody Society, Harvard Medical School, Boston, Massachusetts (M.É.C.); School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia (M.É.C., M.L.J., P.V., S.M.W.R.); Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia (M.É.C., L.A.B., M.E.H., M.L.J., C.F.M.D., A.R., S.M.W.R.); University Department of Rural Health, La Trobe Rural Health School, La Trobe University, Bendigo, Australia (L.A.B.); Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia (M.E.H.); Department of Medicine, The University of Melbourne, Melbourne, Australia (M.E.H., C.F.M.D., A.R.); Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Australia (C.F.M.D., A.R.); and Faculty of Medicine, Monash University, Melbourne, Australia (C.F.M.D.).
Objective:
This study assesses whether chronotype is related to COVID-19 infection and whether there is an interaction with shift work. Methods: This study used a cross-sectional survey of 19,821 U.S. adults. Results: COVID-19 infection occurred in 40% of participants, 32.6% morning and 17.2% evening chronotypes. After adjusting for demographic and socioeconomic factors, shift/remote work, sleep duration, and comorbidities, morning chronotype was associated with a higher (adjusted odds ratio [aOR]: 1.15, 95% CI: 1.10-1.21) and evening chronotype with a lower (aOR: 0.82, 95% CI: 0.78-0.87) prevalence of COVID-19 infection in comparison to an intermediate chronotype. Working exclusively night shifts was not associated with higher prevalence of COVID-19. Morning chronotype and working some evening shifts was associated with the highest prevalence of previous COVID-19 infection (aOR: 1.87, 95% CI: 1.28-2.74). Conclusion: Morning chronotype and working a mixture of shifts increase risk of COVID-19 infection.
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