Educational Attainment Decreases the Risk of COVID-19 Severity in the European Population: A Two-Sample Mendelian Randomization Study

Abstract

Observational studies have reported that the severity of COVID-19 depends not only on physical conditions but also on socioeconomic status, including educational level. Because educational attainment (EA), which measures the number of years of schooling, is moderately heritable, we investigated the causal association of EA on the risk of COVID-19 severity using the Mendelian randomization (MR) approach. A two-sample MR analysis was performed using publicly available summary-level data sets of genome-wide association studies (GWASs). A total of 235 single-nucleotide polymorphisms (SNPs) were extracted as instrumental variables for the exposure of EA from the Social Science Genetic Association Consortium GWAS summary data of 766,345 participants of European ancestry. The effect of each SNP on the outcome of COVID-19 severity risk was obtained from the GWAS summary data of 1,059,456 participants of European ancestry gathered from the COVID-19 Host Genetics Initiative. Using inverse variance weighted method, our MR study shows that EA was significantly associated with a lower risk of COVID-19 severity (odds ratio per one standard deviation increase in years of schooling, 0.540; 95% confidence interval, 0.376–0.777, P = 0.0009). A series of sensitivity analyses showed little evidence of bias. In conclusion, we show for the first time using a two-sample MR approach the associations between higher EA and the lower risk of COVID-19 severity in the European population. However, the genetic or epidemiological mechanisms underlying the association between EA and the risk of COVID-19 severity remain unknown, and further studies are warranted to validate the MR findings and investigate underlying mechanisms.

Factors Associated with SARS-CoV-2 Infection Risk among Healthcare Workers of an Italian University Hospital

“…Physicians are at a significant increased risk too compared to non-HCWs, but the risk is lower compared to nurses, in line with the results reported by Poletti et al [12], while another recent report did not find significantly increased risks according to the job role of the HCW [35]. The different risks for doctors can be possibly explained by the differences in the type of close contacts with the patients and in the duration of the contact in the examined sample; a possible role of a higher education level and training, influencing the appropriate use of the PPE [37], cannot be excluded. Interestingly, in the category of "other HCW", including a heterogeneous group of health personnel such as obstetrics, physiotherapists and various others, the odds of having COVID-19 were not significantly increased compared to non-HCW.…”

“…The results of our study confirm that frontline HCW dealing with COVID-19 patients are at a significantly increased risk when compared to non-HCW: the risk is higher in nurses and nurse aides and other HCW having direct contact with patients [9][10][11][12][13][14][34][35][36][37]. Physicians are at a significant increased risk too compared to non-HCWs, but the risk is lower compared to nurses, in line with the results reported by Poletti et al [12], while another recent report did not find significantly increased risks according to the job role of the HCW [35].…”

Exploring temporal varying demographic and economic disparities in COVID-19 infections in four U.S. areas: based on OLS, GWR, and random forest models

“…Besides, we found that the coefficient of educational attainment turned positive. This finding is against with a claim that educational attainment decreases the risk of COVID-19 severity (Yoshikawa & Asaba, 2021 ).…”

Education Attainment, Intelligence and COVID-19: A Mendelian Randomization Study

“…Thus, the magnitude of association derived from previous observational studies and this MR study cannot be directly compared. It also came to our attention that Yoshikawa et al published a univariable MR analysis very recently by making use of a smaller number of 235 genetic instruments for education attainment [ 27 ] extracted from the latest meta-analysis but a reduced data set comprising 766,345 individuals after excluding the 23andMe samples. In contrast, our current study had higher statistical power due to the use of more than 1110 independent SNPs derived from the same but complete data set consisting of 1,131,881 individuals as genetic instruments [ 16 ].…”

“…In contrast, our current study had higher statistical power due to the use of more than 1110 independent SNPs derived from the same but complete data set consisting of 1,131,881 individuals as genetic instruments [ 16 ]. In addition, they did not conduct multivariable MR analyses to uncover the potential mechanisms, and they did not examine the causal effects of education attainment on SARS-CoV-2 infection and COVID-19 hospitalization [ 27 ]. Likewise, the causal association of intelligence with COVID-19 outcomes was not examined in the study conducted by Yoshikawa et al…”