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Sci Rep . Clinical risk, sociodemographic factors, and SARS-CoV-2 infection over time in Ontario, Canada

tetano

Editor, Senior Moderator
Sci Rep


. 2022 Jun 24;12(1):10534.
doi: 10.1038/s41598-022-13598-z.
Clinical risk, sociodemographic factors, and SARS-CoV-2 infection over time in Ontario, Canada


Jacob A Udell[SUP] 1 2 3 4 5 [/SUP], Bahar Behrouzi[SUP] 6 7 8 9 [/SUP], Atul Sivaswamy[SUP] 6 [/SUP], Anna Chu[SUP] 6 [/SUP], Laura E Ferreira-Legere[SUP] 6 [/SUP], Jiming Fang[SUP] 6 [/SUP], Shaun G Goodman[SUP] 9 10 11 [/SUP], Justin A Ezekowitz[SUP] 11 12 13 [/SUP], Kevin R Bainey[SUP] 11 12 13 [/SUP], Sean van Diepen[SUP] 11 12 13 [/SUP], Padma Kaul[SUP] 11 12 13 [/SUP], Finlay A McAlister[SUP] 11 12 13 [/SUP], Isaac I Bogoch[SUP] 9 14 [/SUP], Cynthia A Jackevicius[SUP] 6 8 15 [/SUP], Husam Abdel-Qadir[SUP] 6 7 16 8 9 [/SUP], Harindra C Wijeysundera[SUP] 6 8 9 17 [/SUP], Dennis T Ko[SUP] 6 8 9 17 [/SUP], Peter C Austin[SUP] 6 8 [/SUP], Douglas S Lee[SUP] 6 16 8 9 [/SUP]



Affiliations
Free article

Abstract

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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