Modifiable and non-modifiable risk factors for COVID-19, and comparison to risk factors for influenza and pneumonia: results from a UK Biobank prospective cohort study
Ho et al.,
Modifiable and non-modifiable risk factors for COVID-19, and comparison to risk factors for influenza and..,
BMJ Open, doi:10.1136/bmjopen-2020-040402
UK Biobank retrospective 235,928 participants using walking pace as a proxy for physical fitness, showing lower risk of COVID-19 hospitalization with an average vs. slow walking pace.
risk of hospitalization, 34.6% lower, RR 0.65, p = 0.007, high activity levels 213 of 123,588 (0.2%), low activity levels 59 of 14,887 (0.4%), adjusted per study, inverted to make RR<1 favor high activity levels, model 2, average vs. slow walking pace, multivariable.
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Ho et al., 19 Nov 2020, retrospective, United Kingdom, peer-reviewed, survey, 13 authors.
Abstract: Open access
Original research
Frederick K Ho ,1 Carlos A Celis-Morales,1,2 Stuart R Gray ,2
S Vittal Katikireddi ,1 Claire L Niedzwiedz ,1 Claire Hastie,1 Lyn D Ferguson,2
Colin Berry,2 Daniel F Mackay,1 Jason MR Gill,2 Jill P Pell,1 Naveed Sattar ,2
Paul Welsh2
To cite: Ho FK, Celis-
Morales CA, Gray SR, et al.
Modifiable and non-modifiable
risk factors for COVID-19,
and comparison to risk
factors for influenza and
pneumonia: results from
a UK Biobank prospective
cohort study. BMJ Open
2020;10:e040402. doi:10.1136/
bmjopen-2020-040402
►► Additional material is
published online only. To view
please visit the journal Online
(http://dx.doi.o rg/10.1136/
bmjopen-2020-040402).
Received 12 May 2020
Revised 08 September 2020
Accepted 11 October 2020
© Author(s) (or their
employer(s)) 2020. Re-use
permitted under CC BY.
Published by BMJ.
1
Institute of Health and
Wellbeing, University of
Glasgow, Glasgow, UK
2
Institute of Cardiovascular and
Medical Sciences, University of
Glasgow, Glasgow, UK
Correspondence to
Dr Paul Welsh;
P aul.Welsh@g lasgow.ac.uk
ABSTRACT
Objectives We aimed to investigate demographic,
lifestyle, socioeconomic and clinical risk factors for
COVID-19, and compared them to risk factors for
pneumonia and influenza in UK Biobank.
Design Cohort study.
Setting UK Biobank.
Participants 49–83 year olds (in 2020) from a general
population study.
Main outcome measures Confirmed COVID-19 infection
(positive SARS-CoV-2 test). Incident influenza and
pneumonia were obtained from primary care data. Poisson
regression was used to study the association of exposure
variables with outcomes.
Results Among 235 928 participants, 397 had confirmed
COVID-19. After multivariable adjustment, modifiable risk
factors were higher body mass index and higher glycated
haemoglobin (HbA1C) (RR 1.28 and RR 1.14 per SD
increase, respectively), smoking (RR 1.39), slow walking
pace as a proxy for physical fitness (RR 1.53), and use of
blood pressure medications as a proxy for hypertension
(RR 1.33). Higher forced expiratory volume in 1 s (FEV1)
and high-density lipoprotein (HDL) cholesterol were both
associated with lower risk (RR 0.84 and RR 0.83 per
SD increase, respectively). Non-modifiable risk factors
included male sex (RR 1.72), black ethnicity (RR 2.00),
socioeconomic deprivation (RR 1.17 per SD increase in
Townsend Index), and high cystatin C (RR 1.13 per SD
increase). The risk factors overlapped with pneumonia
somewhat, less so for influenza. The associations with
modifiable risk factors were generally stronger for
COVID-19, than pneumonia or influenza.
Conclusion These findings suggest that modification of
lifestyle may help to reduce the risk of COVID-19 and could
be a useful adjunct to other interventions, such as social
distancing and shielding of high risk.
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