Characteristics and Behaviors Associated with Prevalent SARS-CoV-2 Infection

Int J Gen Med. 2021 Mar 25;14:1063-1067. doi: 10.2147/IJGM.S305990. eCollection 2021.


Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (Covid-19), has been a serious threat to global health. Previous work has focused primarily on hospitalized patients or on identifying risk factors for disease severity and mortality once the infection has taken place. We sought to leverage the ubiquity of smartphones and mobile applications to study risk factors for Covid-19 infection in a large, geographically heterogenous cohort.

Methods: We analyzed data obtained from the Covid-19 Citizen Science (CCS) Study, a worldwide, mobile application-based cohort. After employing forward selection to identify variables with p values < 0.1, multivariable logistic regression models were utilized to identify independent risk factors associated with prevalent SARS-CoV-2 infection.

Results: Among 36,041 participants in 113 countries and all 50 states in the US, 484 participants had prevalent SARS-CoV-2 infection. After multivariable adjustment, being a healthcare worker, living with at least one school-aged child, having pets at home, and having immunodeficiency were each associated with an increased odds of SARS-CoV-2. The association between pets and prevalent SARS-CoV-2 was driven by dog ownership. After adjustment for the same covariates, Asian or Pacific Islander race, receiving a flu shot within the past year, increased level of education, and smoking or vaping marijuana within the last 30 days were each associated with a lower odds of SARS-CoV-2.

Conclusion: We identified various characteristics and behaviors, many of which are potentially modifiable, associated with prevalent SARS-CoV-2 infection in a world-wide mobile application-based cohort.

Keywords: COVID-19; cohort study; digital health; epidemiology; mobile applications.

Grants and funding

This study was funded by grants IU2CEB021881-01 and 3U2CEB021881-05S1 from the National Institute of Biomedical Imaging and Bioengineering at the National Institutes of Health to Drs. Marcus, Olgin, and Pletcher. The sponsors had no role in study design, data collection, analysis, interpretation of the data, writing of the paper, or the decision to publish the paper.