Clinical and Demographic Factors Associated With COVID-19, Severe COVID-19, and SARS-CoV-2 Infection in Adults
Subclinical infection
DOI:
10.1001/jamanetworkopen.2023.23349
Publication Date:
2023-07-13T15:05:11Z
AUTHORS (1163)
ABSTRACT
Importance Current data identifying COVID-19 risk factors lack standardized outcomes and insufficiently control for confounders. Objective To identify associated with COVID-19, severe SARS-CoV-2 infection. Design, Setting, Participants This secondary cross-protocol analysis included 4 multicenter, international, randomized, blinded, placebo-controlled, vaccine efficacy trials harmonized protocols established by the Prevention Network. Individual-level from participants randomized to receive placebo within each trial were combined analyzed. Enrollment began July 2020 last cutoff was in 2021. adults stable health, at SARS-CoV-2, assigned group trial. Data analyzed April 2022 February 2023. Exposures Comorbid conditions, demographic factors, exposure time of enrollment. Main Outcomes Measures Coprimary COVID-19. Multivariate Cox proportional regression models estimated adjusted hazard ratios (aHRs) 95% CIs baseline covariates, accounting trial, region, calendar time. Secondary among people subclinical infection, Results A total 57 692 (median [range] age, 51 [18-95] years; 11 720 [20.3%] aged ≥65 31 058 [53.8%] male birth) included. The population 3270 American Indian or Alaska Native (5.7%), 7849 Black African (13.6%), 17 678 Hispanic Latino (30.6%), 40 745 White (70.6%). Annualized incidence 13.9% (95% CI, 13.3%-14.4%) 2.0% 1.8%-2.2%) Factors increased rates workplace (high vs low: aHR, 1.35 [95% 1.16-1.58]; medium 1.41 1.21-1.65]; P < .001) living condition (very high low risk: 1.21-1.66]; 1.19 1.08-1.32]; .001). decreased previous infection (aHR, 0.13 0.09-0.19]; .001), age 65 years older (aHR <65 years, 0.57 0.50-0.64]; race race, 0.78 0.67-0.91]; = .002). (American White: 2.61 1.85-3.69]; multiracial 2.19 1.50-3.20]; diabetes 1.54 1.14-2.08]; .005) least 2 comorbidities none, 1.39 1.09-1.76]; .008). In analyses restricted who contracted 1.75 1.32-2.31]; 1.98 1.38-2.83]; 1.49 1.03-2.14]; multiracial: 1.81 1.21-2.69]; overall body mass index per 1-unit increase, 1.03 1.01-1.04]; 1.85 1.37-2.49]; Previous 0.04 0.01-0.14]; Conclusions Relevance this clinical trials, had strongest associations outcomes; results could inform mitigation strategies viruses comparable epidemiological characteristics.
SUPPLEMENTAL MATERIAL
Coming soon ....
REFERENCES (54)
CITATIONS (16)
EXTERNAL LINKS
PlumX Metrics
RECOMMENDATIONS
FAIR ASSESSMENT
Coming soon ....
JUPYTER LAB
Coming soon ....