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. 2021 Feb 8;16(2):e0246447.
doi: 10.1371/journal.pone.0246447. eCollection 2021.

Exposure and risk factors for COVID-19 and the impact of staying home on Michigan residents

Kuan-Han H Wu  1 , Whitney E Hornsby  2 , Bethany Klunder  2 , Amelia Krause  2 , Anisa Driscoll  3   4 , John Kulka  4 , Ryan Bickett-Hickok  4 , Austin Fellows  4 , Sarah Graham  2 , Erin O Kaleba  3 , Salim S Hayek  2 , Xu Shi  5 , Nadia R Sutton  2 , Nicholas Douville  6 , Bhramar Mukherjee  5   7 , Kenneth Jamerson  2 , Chad M Brummett  6 , Cristen J Willer  1   2   8
Affiliations

Exposure and risk factors for COVID-19 and the impact of staying home on Michigan residents

Kuan-Han H Wu et al. PLoS One. .

Abstract

COVID-19 has had a substantial impact on clinical care and lifestyles globally. The State of Michigan reports over 80,000 positive COVID-19 tests between March 1, 2020 and July 29, 2020. We surveyed 8,041 Michigan Medicine biorepository participants in late June 2020. We found that 55% of COVID-19 cases reported no known exposure to family members or to someone outside the house diagnosed with COVID-19. A significantly higher rate of COVID-19 cases were employed as essential workers (45% vs 19%, p = 9x10-12). COVID-19 cases reporting a fever were more likely to require hospitalization (categorized as severe; OR = 4.4 [95% CI: 1.6-12.5, p = 0.005]) whereas respondents reporting rhinorrhea was less likely to require hospitalization (categorized as mild-to-moderate; OR = 0.16 [95% CI: 0.04-0.73, p = 0.018]). African-Americans reported higher rates of being diagnosed with COVID-19 (OR = 4.0 [95% CI: 2.2-7.2, p = 5x10-6]), as well as higher rates of exposure to family or someone outside the household diagnosed with COVID-19, an annual household income < $40,000, living in rental housing, and chronic diseases. During the Executive Order in Michigan, African Americans, women, and the lowest income group reported worsening health behaviors and higher overall concern for the potential detrimental effects of the pandemic. The higher risk of contracting COVID-19 observed among African Americans may be due to the increased rates of working as essential employees, lower socioeconomic status, and exposure to known positive cases. Continued efforts should focus on COVID-19 prevention and mitigation strategies, as well as address the inequality gaps that result in higher risks for both short-term and long-term health outcomes.

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Conflict of interest statement

We disclose that Dr. Willer’s spouse works for Regeneron Pharmaceuticals Inc., and that Dr. Brummett is a consultant for Heron Therapeutics and Alosa Health. These disclosures do not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Confirmed and probable COVID-19 cases for the state of Michigan from March 1, 2020 to July 29, 2020.
Fig 2
Fig 2. Study enrollment.
Fig 3
Fig 3
a) Risk factors associated with COVID-19 in comparison to those without COVID-19, and b) risk factors associated with a severe course of COVID-19 in comparison to those with a mild or moderate course of COVID-19.
Fig 4
Fig 4. Differences in clinical and social risk factors between African American and European American survey respondents.
Fig 5
Fig 5. Behavioral change by sex (Female versus Male), income (<$40,000 versus $40,000–100,00 versus >$100,000 annual house income), and race (African versus European American).
Fig 6
Fig 6. COVID-19 status, COVID-19 risk factors, and chronic disease differences by race (African versus European American).
See this image and copyright information in PMC

References

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