TY - JOUR
T1 - Risk factors for recognized and unrecognized SARS-CoV-2 infection
T2 - a seroepidemiologic analysis of the Prospective Urban Rural Epidemiology (PURE) study
AU - Leong, Darryl P.
AU - Loeb, Mark
AU - Mony, Prem K.
AU - Rangarajan, Sumathy
AU - Mushtaha, Maha
AU - Miller, Matthew S.
AU - Dias, Mary
AU - Yegorov, Sergey
AU - Mamatha, V.
AU - Caklili, Ozge Telci
AU - Temizhan, Ahmet
AU - Szuba, Andrzej
AU - Abat, Marc Evans M.
AU - Mat-Nasir, Nafiza
AU - Diaz, Maria Luz
AU - Khansaheb, Hamda
AU - Lopez-Jaramillo, Patricio
AU - Duong, My Linh
AU - Teo, Koon K.
AU - Poirier, Paul
AU - Oliveira, Gustavo
AU - Avezum, Álvaro
AU - Yusuf, Salim
N1 - Publisher Copyright:
Copyright © 2024 Leong et al.
PY - 2024/2
Y1 - 2024/2
N2 - There are limited data on individual risk factors for SARS-CoV-2 infection (including unrecognized infection). In this seroepidemiologic substudy of an ongoing prospective cohort study of community-dwelling adults, participants were thoroughly characterized pre-pandemic. The SARS-CoV-2 infection was ascertained by serology. Among 8,719 participants from 11 high-, middle-, and low-income countries, 3,009 (35%) were seropositive for SARS-CoV-2. Characteristics independently associated with seropositivity were younger age (odds ratio, OR; 95% confidence interval, CI, per five-year increase: 0.95; 0.91–0.98) and body mass index >25 kg/m2 (OR, 95% CI: 1.16, 1.01–1.34). Smoking (as compared with never smoking, OR, 95% CI: 0.83, 0.70–0.97) and COVID-19 vaccination (OR, 95% CI: 0.70, 0.60–0.82) were associated with a reduced risk of seropositivity. Among seropositive participants, 83% were unaware of having been infected with SARS-CoV-2. Seropositivity and a lack of awareness of infection were more common in lower-income countries. The COVID-19 vaccination reduces the risk of SARS-CoV-2 infection (including recognized and unrecognized infections). Overweight or obesity is an independent risk factor for SARS-CoV-2 infection. Infection and lack of infection awareness are more common in lower-income countries. IMPORTANCE In this large, international study, evidence of SARS-CoV-2 infection was obtained by testing blood specimens from 8,719 community-dwelling adults from 11 countries. The key findings are that (i) the large majority (83%) of community-dwelling adults from several high-, middle-, and low-income countries with blood test evidence of SARS-CoV-2 infection were unaware of this infection—especially in lower-income countries; and (ii) overweight/obesity predisposes to SARS-CoV-2 infection, while COVID-19 vaccination is associated with a reduced risk of SARS-CoV-2 infection. These observations are not attributable to other individual characteristics, highlighting the importance of the COVID-19 vaccination to prevent not only severe infection but possibly any infection. Further research is needed to understand the mechanisms by which overweight/obesity might increase the risk of SARS-CoV-2 infection.
AB - There are limited data on individual risk factors for SARS-CoV-2 infection (including unrecognized infection). In this seroepidemiologic substudy of an ongoing prospective cohort study of community-dwelling adults, participants were thoroughly characterized pre-pandemic. The SARS-CoV-2 infection was ascertained by serology. Among 8,719 participants from 11 high-, middle-, and low-income countries, 3,009 (35%) were seropositive for SARS-CoV-2. Characteristics independently associated with seropositivity were younger age (odds ratio, OR; 95% confidence interval, CI, per five-year increase: 0.95; 0.91–0.98) and body mass index >25 kg/m2 (OR, 95% CI: 1.16, 1.01–1.34). Smoking (as compared with never smoking, OR, 95% CI: 0.83, 0.70–0.97) and COVID-19 vaccination (OR, 95% CI: 0.70, 0.60–0.82) were associated with a reduced risk of seropositivity. Among seropositive participants, 83% were unaware of having been infected with SARS-CoV-2. Seropositivity and a lack of awareness of infection were more common in lower-income countries. The COVID-19 vaccination reduces the risk of SARS-CoV-2 infection (including recognized and unrecognized infections). Overweight or obesity is an independent risk factor for SARS-CoV-2 infection. Infection and lack of infection awareness are more common in lower-income countries. IMPORTANCE In this large, international study, evidence of SARS-CoV-2 infection was obtained by testing blood specimens from 8,719 community-dwelling adults from 11 countries. The key findings are that (i) the large majority (83%) of community-dwelling adults from several high-, middle-, and low-income countries with blood test evidence of SARS-CoV-2 infection were unaware of this infection—especially in lower-income countries; and (ii) overweight/obesity predisposes to SARS-CoV-2 infection, while COVID-19 vaccination is associated with a reduced risk of SARS-CoV-2 infection. These observations are not attributable to other individual characteristics, highlighting the importance of the COVID-19 vaccination to prevent not only severe infection but possibly any infection. Further research is needed to understand the mechanisms by which overweight/obesity might increase the risk of SARS-CoV-2 infection.
KW - COVID-19
KW - KEYWORDS SARS-CoV-2
KW - low-income countries
KW - pandemic
KW - seroepidemiology
KW - transmission
UR - http://www.scopus.com/inward/record.url?scp=85184517748&partnerID=8YFLogxK
U2 - 10.1128/spectrum.01492-23
DO - 10.1128/spectrum.01492-23
M3 - Artículo Científico
C2 - 38214526
AN - SCOPUS:85184517748
SN - 2165-0497
VL - 12
JO - Microbiology Spectrum
JF - Microbiology Spectrum
IS - 2
ER -
