Risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections: a nationwide population-based study

Abstract

Background: The coronavirus disease 2019 has rapidly turned into a public health emergency worldwide; however, the risk factors for infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have not been well-described. We aimed to identify the clinical risk factors for SARS-CoV-2 infections in Korea, where social distancing and face masks have been strongly recommended.Methods: The data of individuals who underwent the reverse transcription polymerase chain reaction test for SARS-CoV-2 between January 3 and May 31, 2020 were retrieved from the Health Insurance Review and Assessment Service dataset. We used multivariable logistic regression models to identify the risk factors for SARS-CoV-2 infections in the population. Results:We retrieved the results of 219,729 SARS-CoV-2 tests, of which 7,333 were positive results. In the multivariable analysis, female sex was associated with a higher risk of testing positive for SARS-CoV-2 [odds ratio (OR) =1.30, 95% confidence interval (CI): 1.24-1.37, P<0.0001]. Additionally, populations living in areas that had large outbreaks of COVID-19 were at an increased risk of testing positive for SARS-CoV-2 (OR =6.87, 95% CI: 6.55-7.21, P<0.0001). The odds of a positive test were greater for the Medical Aid beneficiaries (OR =1.99, 95% CI: 1.82-2.18, P<0.0001) than for the National Health Insurance beneficiaries.Individuals with diabetes mellitus (DM) were more likely to test positive (OR =1.15, 95% CI: 1.07-1.24, P=0.0002).Conclusions: Women, individuals living in areas with large outbreaks of COVID-19, Medical Aid beneficiaries, and individuals with DM might have greater risks of contracting SARS-CoV-2 infections despite practicing social distancing and using face masks.

Lung epithelial and endothelial damage, loss of tissue repair, inhibition of fibrinolysis, and cellular senescence in fatal COVID-19

“…Pulmonary and systemic inflammation, vascular-related complications, including pulmonary embolisms, abnormal microthrombi, strokes, and direct blood vessel damage highlight the critical pathogenic involvement of endothelial dysfunction in severe COVID-19 (6,7). Key risk factors associated with severe COVID-19 include advanced age (>80 years), diabetes, obesity, male gender, and hypertension (8)(9)(10)(11)(12). Alveolar-capillary barrier dysfunction, which is characterized by impaired gas exchange, vascular leakage, and reduced fluid clearance, is a major cause of the acute respiratory distress syndrome (ARDS) in patients with severe COVID-19.…”

“…However, key questions remain regarding the factors associated with severe and fatal disease outcomes. Moreover, delineating the mechanisms underlying the increased disease severity in individuals with advanced age, hypertension, diabetes, and other risk factors remains paramount (8)(9)(10)(11). In the present study, lung autopsy tissue samples from 18 patients with fatal COVID-19 and antemortem plasma samples from 6 of these cases were examined using viral genomics, host genetic susceptibility single-nucleotide polymorphism (SNP) analysis, serum antibody and multiplexed cytokine and chemokine protein measurements, and pulmonary transcriptomic and imaging analyses to better understand the molecular pathological processes underlying COVID-19 respiratory failure.…”

“…Pulmonary and systemic inflammation with vascular-related complications, including pulmonary embolisms, abnormal microthrombi, strokes, and direct blood vessel damage, highlight the critical pathogenic involvement of endothelial dysfunction in severe COVID-19 (6,7). Key risk factors associated with severe COVID-19 include advanced age (>80 years), diabetes, obesity, male gender, and hypertension (8)(9)(10)(11)(12).…”

“…However, key questions remain regarding the factors associated with severe and fatal disease outcomes. Moreover, delineating the mechanisms underlying the increased disease severity in individuals with advanced age, hypertension, diabetes, and other risk factors remains paramount (8)(9)(10)(11).…”

Covid-19 and Vitamin D Deficiency: A Scientometric Assessment of Global Publications during 2020-21

“…3,4 In addition to comorbidities, several other risk factors, such as female sex, lack of Covid-19 appropriate behavior, large households, BCG vaccination, etc., are presumed to play a role in the Covid-19-related morbidity and mortality. [5][6][7][8] One such risk factor which has been postulated to contribute to either acquisition or progression of Covid-19 is Vitamin D deficiency (VDD). 9Since the onset of the Covid-19 pandemic, the role of VDD has been a topic of intense research.…”