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, F. K. et al. (2020) 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, 10, e040402. (doi: 10.1136/bmjopen-2020-040402) (PMID:33444201) (PMCID:PMC7678347)

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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.

Item Type:Articles
Additional Information:The work in this study is supported by the British Heart Foundation Centre of Research Excellence Grant RE/18/6/34217. CLN acknowledges funding from a Medical Research Council Fellowship (MR/R024774/1). SVK acknowledges funding from the Medical Research Council (MC_UU_12017/13), Scottish Government Chief Scientist Office (SPHSU13), and NRS Senior Clinical Fellowship (SCAF/15/02).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Berry, Professor Colin and Katikireddi, Professor Vittal and Hastie, Dr Claire and Celis, Dr Carlos and Gray, Dr Stuart and Gill, Professor Jason and Ferguson, Dr Lyn and Ho, Dr Frederick and Welsh, Dr Paul and Pell, Professor Jill and Mackay, Professor Daniel and Sattar, Professor Naveed and Niedzwiedz, Dr Claire
Authors: Ho, F. K., Celis-Morales, C. A., Gray, S. R., Katikireddi, S. V., Niedzwiedz, C. L., Hastie, C., Ferguson, L. D., Berry, C., Mackay, D. F., Gill, J. M.R., Pell, J. P., Sattar, N., and Welsh, P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN:2044-6055
ISSN (Online):2044-6055
Copyright Holders:Copyright © Author(s) (or their employer(s)) 2020
First Published:First published in BMJ Open 10:e040402
Publisher Policy:Reproduced under a Creative Commons license

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
303944BHF Centre of ExcellenceRhian TouyzBritish Heart Foundation (BHF)RE/18/6/34217CAMS - Cardiovascular Science
302182A machine learning approach to understanding comorbidity between mental and physical health conditionsClaire NiedzwiedzMedical Research Council (MRC)MR/R024774/1HW - Public Health
Medical Research Council (MRC)MC_UU_12017/13
Chief Scientist Office (CSO)SPHSU13
172690Understanding the impacts of welfare policy on health: A novel data linkage studySrinivasa KatikireddiChief Scientist Office (CSO)SCAF/15/02HW - Public Health