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Risk Factors for Developing COVID-19: A Population-Based Longitudinal Study (COVIDENCE UK)
Queen Mary University of London - Barts and The London School of Medicine and Dentistry; Queen Mary University of London - Institute of Population Health Sciences; Queen Mary University of London - Asthma UK Centre for Applied Research; Queen Mary University of London - Wolfson Institute of Population Health
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 st May 2020 to 5 th 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 odds ratios (aORs) for associations between potential risk factors and risk of COVID-19.
Findings: We recorded 446 incident cases of COVID-19 in 15,227 participants (2.9%). Increased risk of developing COVID-19 was independently associated with Asian/Asian British vs . White ethnicity (aOR 2.31, 95% CI 1.35-3.95), household overcrowding (aOR per additional 0.5 people/bedroom 1.26, 1.11-1.43) , any vs . no visits to/from other households in previous week (aOR 1.33, 1.07-1.64), number of visits to indoor public places (aOR per extra visit per week 1.05, 1.01-1.09), frontline occupation excluding health/social care vs. no frontline occupation (aOR 1.49, 1.12-1.98), and raised body mass index (BMI) (aOR 1.51 [1.20-1.90] for BMI 25.0-30.0 kg/m 2 and 1.38 [1.05-1.82] for BMI >30.0 kg/m 2 vs. BMI <25.0 kg/m 2 ). Atopic disease was independently associated with decreased risk (aOR 0.76, 0.59-0.98). No independent associations were seen for age, sex, other medical conditions, diet, or micronutrient supplement use.
Interpretation: After rigorous adjustment for factors influencing exposure to SARS-CoV-2, Asian/Asian British ethnicity and raised BMI were associated with increased risk of developing COVID-19, while atopic disease was associated with decreased risk.
Trial Registration: It is registered with ClinicalTrials.gov (NCT04330599).
Funding: Barts Charity, Health Data Research UK
Declaration of Interest: None to declare.
Ethical Approval: The study was sponsored by Queen Mary University of London and approved by Leicester South Research Ethics Committee (ref 20/EM/0117).
Holt, Hayley and Talaei, Mohammad and Greenig, Matthew and Zenner, Dominik and Symons, Jane and Relton, Clare and Young, Katherine S. and Davies, Molly R. and Thompson, Katherine N. and Ashman, Jed and Rajpoot, Sultan Saeed and Kayyale, Ahmed Ali and El Rifai, Sarah and Lloyd, Philippa J. and Jolliffe, David A. and Finer, Sarah and Ilidriomiti, Stamatina and Miners, Alec and Hopkinson, Nicholas S. and Alam, Bodrul and Pfeffer, Paul E. and McCoy, David and Davies, Gwyneth A. and Lyons, Ronan A. and Griffiths, Christopher J. and Kee, Frank and Sheikh, Aziz and Breen, Gerome and Shaheen, Seif O. and Martineau, Adrian R., Risk Factors for Developing COVID-19: A Population-Based Longitudinal Study (COVIDENCE UK). Available at SSRN: https://ssrn.com/abstract=3817437 or http://dx.doi.org/10.2139/ssrn.3817437
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