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Some risk factors may differ from those which predispose to severe COVID-19 disease – study

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Individuals who suffer from allergic conditions such as hay fever, rhinitis, or atopic eczema may have a reduced risk of COVID-19 infection, particularly if they also have asthma, says large population-based research published in the respiratory journal Thorax.

And, contrary to previous research, the research reveals that older age, male sex, and other underlying illnesses are not associated with an increased risk of infection.

However, the data indicate that Asian ethnicity, obesity, household overcrowding, indoor socializing with other households, and working in a people-facing profession other than health and social care are all independently related with a high risk of contracting COVID-19.

According to the researchers, a growing body of evidence suggests that at least some risk factors for developing COVID-19 may be distinct from those associated with severe disease and the demand for urgent care.

To find more, between May 2020 and February 2021, the researchers collected detailed information on potential risk factors for COVID-19 infection among UK people. These variables included demographic, socioeconomic, lifestyle, diet, medical treatment, and underlying diseases.

When participants enrolled in the study, they were asked to provide information about their age, household circumstances, work, lifestyle, weight, height, long-standing medical issues, medication use, vaccination status, food and supplement intake.

15,227 participants completed at least one consecutive monthly follow-up questionnaire 30 days or more after enrolling in the study, and 14,348 participants completed the final questionnaire on or before 5 February 2021.

The average age of the respondents was 59; 70 percent were female; and 95 percent identified as Ethnic group as white. 

During the study period, 446 subjects (almost 3 percent) had at least one episode of proven COVID-19 infection, as indicated by swab (PCR or lateral flow) test, and 32 were hospitalized.

The team took into account a variety of possibly important variables: age: sex: duration of study participation:  ethnicity: testing frequency ethnicity; education; deprivation; household income; housing type; number of people per bedroom; schoolchildren at home; ownership of a pet dog; shielding; socializing with other households; visits to shops and other indoor public places; travel to work or study; frontline worker status; physical activity; alcohol consumption; weight (BMI); asthma; allergies; use of immune suppressant drugs, inhaled corticosteroids, and bronchodilators; BCG vaccination status;  fruit, vegetable, and salad intake; and use of nutritional supplements.

As a result, certain indicators emerged as individually related with an increased risk of acquiring COVID-19.

Asian/Asian British people were more than twice as likely to contract the virus than their white counterparts.

Similarly, household overcrowding; social interaction with other households in the prior week; frequency of visits to indoor public areas; a people-facing role other than health and social care; and overweight/obesity were all related with an increased risk.

And the findings indicated that the more individuals living in a household and the more visits to indoor public spaces, the greater the risk of infection.

However, atopic disease (caused by allergens), which encompasses eczema/dermatitis and hay fever/allergic rhinitis, was independently related with a 23% reduced risk of contracting the infection than individuals without atopic disease or asthma.

And the danger was significantly lower for those with atopic disease and asthma: 38 percent. Even after adjusting for the usage of steroid inhalers, this connection remained.

Taking medicines that inhibit the immune system (immunosuppressants) was also related with a 53 percent reduction in the risk of COVID-19 infection, although this may reflect these individuals’ increased resistance to infection, the researchers note.

However, no correlation was found between infection risk with age, sex, other medical problems, nutrition, or supplement use.

As this is an observational study, it cannot establish the main cause. Additionally, the researchers acknowledge the study’s limitations.

These include the absence of oversight for swab testing and dependence on the findings of routine testing, which is typically prompted by symptoms, potentially missing those with symptomless infection.

Due to the fact that participants volunteered, some ethnic minorities, particularly those of black, African, and Caribbean origin, were underrepresented in the study.

Nevertheless, they concluded:

“This large, population-based prospective study shows that there is limited overlap between risk factors for developing COVID-19 versus those for intensive care unit admission and death, as reported in hospitalised cohorts.”

Source: 10.1136/thoraxjnl-2021-217487

Image Credit: Getty

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