Journal
SCIENTIFIC REPORTS
Volume 12, Issue 1, Pages -Publisher
NATURE PORTFOLIO
DOI: 10.1038/s41598-022-13598-z
Keywords
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Categories
Funding
- Canadian Institutes of Health Research (CIHR) Strategy for Patient-Oriented Research Innovative Clinical Trial Multi-year Grant [MYG-151211]
- Ted Rogers Centre for Heart Research Innovation Fund-COVID-19 Award
- Peter Munk Cardiac Care Innovation Fund
- COVID-19 Rapid Research Funding Opportunity-Clinical Management and Health Systems Interventions from the Institute of Circulatory and Respiratory Health (ICRH)-CIHR operating Grant [VR4-172736]
- Government of Ontario Early Researcher Award [ER15-11-037]
- Women's College Research Institute
- University of Toronto MD/PhD studentship award
- CANHEART SPOR Graduate Studentship Award
- Ted Rogers Centre for Heart Research Doctoral Award
- Heart and Stroke Foundation
- Heart and Stroke Foundation of Ontario/University of Toronto Polo Chair
- Department of Medicine, Women's College Hospital
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This study aimed to investigate whether early public health interventions in 2020 mitigated the association between sociodemographic and clinical risk factors and SARS-CoV-2 infection. The findings showed that the risk factors for infection, such as age, sex, income, and racial/ethnic diversity, varied over time. Efforts are needed to reduce the risk of infection among the highest risk individuals residing in the most racially/ethnically diverse communities.
We aimed to determine whether early public health interventions in 2020 mitigated the association of sociodemographic and clinical risk factors with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We conducted a population-based cohort study of all adults in Ontario, Canada who underwent testing for SARS-CoV-2 through December 31, 2020. The outcome was laboratory-confirmed SARS-CoV-2 infection, determined by reverse transcription polymerase chain reaction testing. Adjusted odds ratios (ORs) were determined for sociodemographic and clinical risk factors before and after the first-wave peak of the pandemic to assess for changes in effect sizes. Among 3,167,753 community-dwelling individuals, 142,814 (4.5%) tested positive. The association between age and SARS-CoV-2 infection risk varied over time (P-interaction < 0.0001). Prior to the first-wave peak, SARS-CoV-2 infection increased with age whereas this association reversed thereafter. Risk factors that persisted included male sex, residing in lower income neighborhoods, residing in more racially/ethnically diverse communities, immigration to Canada, hypertension, and diabetes. While there was a reduction in infection rates after mid-April 2020, there was less impact in regions with higher racial/ethnic diversity. Immediately following the initial peak, individuals living in the most racially/ethnically diverse communities with 2, 3, or >= 4 risk factors had ORs of 1.89, 3.07, and 4.73-fold higher for SARS-CoV-2 infection compared to lower risk individuals in their community (all P < 0.0001). In the latter half of 2020, this disparity persisted with corresponding ORs of 1.66, 2.48, and 3.70-fold higher, respectively. In the least racially/ethnically diverse communities, there was little/no gradient in infection rates across risk strata. Further efforts are necessary to reduce the risk of SARS-CoV-2 infection among the highest risk individuals residing in the most racially/ethnically diverse communities.
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