COVID-19-related hospital admission in spouses of partners in at-risk occupations

Abstract

Objective: This study aimed to quantify the risk of COVID-19-related hospital admission in spouses living with partners in at-risk occupations in Denmark during 2020-21.

Methods: Within a registry-based cohort of all Danish employees (N=2 451 542), we identified cohabiting couples, in which at least one member (spouse) held a job that according to a job exposure matrix entailed low risk of occupational exposure to SARS-CoV-2 (N=192 807 employees, 316 COVID-19 hospital admissions). Risk of COVID-19-related hospital admission in such spouses was assessed according to whether their partners were in jobs with low, intermediate or high risk for infection. Overall and sex-specific incidence rate ratios (IRR) of COVID-19-related hospital admission were computed by Poisson regression with adjustment for relevant covariates.

Results: The risk of COVID-19-related hospital admission was increased among spouses with partners in high-risk occupations [adjusted IRR (IRR_adj)1.59, 95% confidence interval (CI) 1.1-2.2], but not intermediate-risk occupations (IRR_adj 0.97 95% 0.8-1.3). IRR for having a partner in a high-risk job was elevated during the first three pandemic waves but not in the fourth (IRR_adj 0.48 95% CI 0.2-1.5). Sex did not modify the risk of hospital admission.

Conclusions: SARS-CoV-2 transmission at the workplace may pose an increased risk of severe COVID-19 among spouses in low-risk jobs living with partners in high-risk jobs, which emphasizes the need for preventive measures at the workplace in future outbreaks of epidemic contagious disease. When available, effective vaccines seem essential.

Figure 1

Identification of spouses (low-risk occupations) to partners in low-, intermediate- and high-risk occupations based upon the DOC*X cohort. * Including partners of same sex. # High-risk occupations were derived from sex-stratified follow-up analyses of adjusted risk of COVID-19 hospital admission (Poisson regression providing incidence rate ratios) by all 4-digit DISCO-08 job codes using the entire source population [N=2 451 542, results provided in supplementary table 1, methods detailed in (4)].