| Title: | Lifestyle risk factors, inflammatory mechanisms, and COVID-19 hospitalization: A community-based cohort study of 387,109 adults in UK |
| Journal: | Brain Behavior and Immunity |
| Published: | 23 May 2020 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/32454138/ |
| DOI: | https://doi.org/10.1016/j.bbi.2020.05.059 |
| URL: | https://europepmc.org/articles/pmc7245300?pdf=render |
| Citations: | 463 (99 in last 2 years) as of 8 Aug 2024 |
Publication 5323
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Abstract
We conducted the first large-scale general population study on lifestyle risk factors (smoking, physical inactivity, obesity, and excessive alcohol intake) for COVID-19 using prospective cohort data with national registry linkage to hospitalisation. Participants were 387,109 men and women (56.4 ± 8.8 yr; 55.1% women) residing in England from UK Biobank study. Physical activity, smoking, and alcohol intake, were assessed by questionnaire at baseline (2006-2010). Body mass index, from measured height and weight, was used as an indicator of overall obesity. Outcome was cases of COVID-19 serious enough to warrant a hospital admission from 16-March-2020 to 26-April-2020. There were 760 COVID-19 cases. After adjustment for age, sex and mutually for each lifestyle factor, physical inactivity (Relative risk, 1.32, 95% confidence interval, 1.10, 1.58), smoking (1.42;1.12, 1.79) and obesity (2.05 ;1.68, 2.49) but not heavy alcohol consumption (1.12; 0.93, 1.35) were all related to COVID-19. We also found a dose-dependent increase in risk of COVID-19 with less favourable lifestyle scores, such that participants in the most adverse category had 4-fold higher risk (4.41; 2.52-7.71) compared to people with the most optimal lifestyle. C-reactive protein levels were associated with elevated risk of COVID-19 in a dose-dependent manner, and partly (10-16%) explained associations between adverse lifestyle and COVID-19. Based on UK risk factor prevalence estimates, unhealthy behaviours in combination accounted for up to 51% of the population attributable fraction of severe COVID-19. Our findings suggest that an unhealthy lifestyle synonymous with an elevated risk of non-communicable disease is also a risk factor for COVID-19 hospital admission, which might be partly explained by low grade inflammation. Adopting simple lifestyle changes could lower the risk of severe infection.</p>
25 Keywords
- Adult
- Aged
- Alcohol Drinking
- Betacoronavirus
- Body Mass Index
- C-Reactive Protein
- COVID-19
- Cohort Studies
- Coronavirus Infections
- Exercise
- Female
- Hospitalization
- Humans
- Life Style
- Male
- Middle Aged
- Obesity
- Pandemics
- Pneumonia, Viral
- Prospective Studies
- Risk Factors
- SARS-CoV-2
- Smoking
- Surveys and Questionnaires
- United Kingdom
4 Authors
- Mark Hamer
- Mika Kivimäki
- Catharine R Gale
- G David Batty
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