Document Type : Original Article
Authors
- Fatemeh Rezaei 1
- Mousa Ghelichi-Ghojogh 2
- Farzaneh Mobasheri 3
- Sanaz Amiri 4
- Elahe Piraee 5
- Seyed Sina Dehghani 6
- Amir Hossein Hassani 6
- Kimia Jokari 4
- Alireza Mirahmadizadeh 7
1 Department of Epidemiology, Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
2 Neonatal and Children’s Research Center, Department of Biostatistics and Epidemiology, School of Health, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
3 Department of Epidemiology, Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
4 Department of Epidemiology, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
5 Department of Epidemiology, Center for Healthcare Data Modeling Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
6 School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
7 Department of Epidemiology, Non-communicable Diseases Research Center, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract
Background: Coronavirus disease of 2019 (COVID-19) became a public health threat to global public health in late 2019. This study aimed to investigate the correlation between lifestyle factors and the COVID-19 epidemiological indicators, including cumulative incidence rate, the cumulative rate of death, recovery rate, and case fatality rate.
Methods: In this ecological study, aggregate data were used. Information about COVID-19 for each country was retrieved from https://www.worldometers.info/ from the date of the first report until November 30th, 2020. The information on the prevalence of smoking, alcohol consumption, and obesity in 2019 was collected from https://www.indexmundi.com/. Moreover, the information on the prevalence of physical inactivity was obtained from the WHO website. We drew scatter plots of lifestyle factors based on COVID-19 indices.
Results: Results showed that the cumulative incidence rate and cumulative rate of death had significant direct correlations with the prevalence of obesity, physical inactivity, smoking, and alcohol consumption (P<0.05). This means that the countries with a high prevalence of obesity, physical inactivity, smoking, and alcohol consumption had increased indicators such as the cumulative incidence rate and cumulative rate of death (P<0.05). There were also significant inverse correlations between the recovery rate and the prevalence of smoking and alcohol consumption (P<0.05).
Conclusion: There are significant correlations between the cumulative incidence rate, the cumulative rate of death, and the recovery rate of COVID-19 with unhealthy lifestyle behaviors. Therefore, it is necessary to develop lifestyle modification strategies that can lead to reduction of the morbidity and mortality of this disease.
Highlights
Fatemeh Rezaei (Google Scholar)
Alireza Mirahmadizadeh (Google Scholar)
Keywords
- Bogoch II, Watts A, Thomas-Bachli A, Huber C, Kraemer MU, Khan K. Pneumonia of unknown aetiology in Wuhan, China: potential for international spread via commercial air travel. J Travel Med. 2020;27(2):taaa008. doi: 10.1093/jtm/taaa008. PMID: 31943059; PMCID: PMC7107534.
- Kalteh EA, Sofizadeh A, Fararooei M, Ghojogh MG, Aljalili S. Measures of Mortality in Coronavirus (COVID-19) Compared with SARS and MERS. J Cell Mol 2020;5(2):97-101. doi:10.22037/jcma.v5i2.30220.
- Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet. 2020;395(10223):497-506. doi:10.1016/S0140-6736(20)30183-5. PMID: 31986264; PMCID: PMC7159299.
- Lippi G, Henry BM. Active smoking is not associated with severity of coronavirus disease 2019 (COVID-19). Eur J Intern Med. 2020;75:107-8. doi:10.1016/j.ejim.2020.03.014. PMID: 32192856; PMCID: PMC7118593.
- Tartof SY, Qian L, Hong V, Wei R, Nadjafi RF, Fischer H, et al. Obesity and mortality among patients diagnosed with COVID-19: results from an integrated health care organization. Ann Intern Med. 2020;173(10):773-81. doi:10.7326/M20-3742. PMID: 32783686.
- Kass DA, Duggal P, Cingolani O. Obesity could shift severe COVID-19 disease to younger ages. The Lancet. 2020;395(10236):1544-5. doi:10.1016/S0140-6736(20)31024-2. PMID: 32380044; PMCID: PMC7196905.
- Tsigaris P, Teixeira da Silva JA. Smoking prevalence and COVID-19 in Europe. Nicotine Tob Res. 2020;22(9):1646-9. doi:10.1093/ntr/ntaa121. PMID: 32609839.
- Patanavanich R, Glantz SA. Smoking is associated with COVID-19 progression: a meta-analysis. Nicotine Tob Res. 2020;22(9):1653-6. doi:10.1093/ntr/ntaa082. PMID: 32399563.
- Chevance A, Gourion D, Hoertel N, Llorca P-M, Thomas P, Bocher R, et al. Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review. L'encephale. 2020;46(3):193-201. doi:10.1016/j.encep.2020.04.005. PMID: 32370982; PMCID: PMC7174154.
- Sallis JF, Pratt M. Multiple benefits of physical activity during the Coronavirus pandemic. Braz J Phys Act Health. 2020;25:1-5. doi:10.12820/rbafs.25e0112.
- Index Mundi. Smoking prevalence, total (ages 15+) - Country Ranking 2016. Cited 2020 Dec 20. Available from: https://www.indexmundi.com/facts/indicators/SH.PRV.SMOK/rankings.
- Index Mundi. Total alcohol consumption per capita (liters of pure alcohol, projected estimates, 15+ years of age) - Country Ranking 2016. Cited 2020 Dec 20. Available from: https://www.indexmundi.com/facts/indicators/SH.ALC.PCAP.LI/rankings.
- Index Mundi. Obesity - adult prevalence rate 2016. Cited 2020 Dec 20. Available from: https://www.indexmundi.com/map/?v=2228.
- Prevalence of insufficient physical activity among adults Data by country 2016. Cited 2020 Dec 20. Available from: https://apps.who.int/gho/data/view.main.2463.
- Prevalence of insufficient physical activity among adults aged 18+ years. Cited 2022 Feb 20. Available from: https://www.who.int/data/gho/indicator-metadata-registry/imr-details/2381.
- Cai Q, Chen F, Wang T, Luo F, Liu X, Wu Q, et al. Obesity and COVID-19 severity in a designated hospital in Shenzhen, China. Diabetes care. 2020;43(7):1392-8. doi:10.2337/dc20-0576.
- Rezaei F, Tabatabaee H-R, Rahmanian V, Mirahmadizadeh A, Hassanipour S. The correlation between bladder cancer and obesity, overweight, physical inactivity, and tobacco use: an ecological study in Asian countries. Ann Glob Health. 2019;85(1):102. doi:10.5334/aogh.2545. PMID: 31298827; PMCID: PMC6634367.
- Honce R, Schultz-Cherry S. Impact of obesity on influenza A virus pathogenesis, immune response, and evolution. Front Immunol. 2019;10:1071. doi:10.3389/fimmu.2019.01071. PMID: 31134099; PMCID: PMC6523028.
- Berlin I, Thomas D, Le Faou A-L, Cornuz J. COVID-19 and smoking. Nicotine Tob Res. 2020;22(9):1650-2. doi:10.1093/ntr/ntaa059. PMID: 32242236.
- Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. New England journal of medicine. 2020;382(13):1199-207. doi:10.1056/NEJMoa2001316. PMID: 31995857; PMCID: PMC7121484.
- Liu W, Tao Z-W, Wang L, Yuan M-L, Liu K, Zhou L, et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chinese medical journal. 2020;133(09):1032-8. doi:10.1097/CM9.0000000000000775. PMID: 32118640.
- Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The lancet. 2020;395(10229):1054-62. doi:10.1016/S0140-6736(20)30566-3.
- Vardavas CI, Nikitara K. COVID-19 and smoking: A systematic review of the evidence. Tob Induc Dis. 2020;18. doi:10.18332/tid/119324. PMID: 32206052; PMCID: PMC7083240.
- Fu L, Wang B, Yuan T, Chen X, Ao Y, Fitzpatrick T, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: a systematic review and meta-analysis. J Infect. 2020;80(6):656-65. doi:10.1016/j.jinf.2020.03.041. PMID: 32283155; PMCID: PMC7151416.
- Dye JA, Adler KB. Effects of cigarette smoke on epithelial cells of the respiratory tract. Thorax. 1994;49(8):825. doi:10.1136/thx.49.8.825. PMID: 8091331; PMCID: PMC475133.
- Simons D, Shahab L, Brown J, Perski O. The association of smoking status with SARS‐CoV‐2 infection, hospitalization and mortality from COVID‐19: a living rapid evidence review with Bayesian meta‐analyses (version 7). Addiction. 2021;116(6):1319-68. doi:10.1111/add.15276. PMC7590402.
- Woods JA, Hutchinson NT, Powers SK, Roberts WO, Gomez-Cabrera MC, Radak Z, et al. The COVID-19 pandemic and physical activity. Sports Medicine and Health Science. 2020;2(2):55-64. doi:10.1016/j.smhs.2020.05.006. PMID: 34189484.
- Zhang X, Li X, Sun Z, He Y, Xu W, Campbell H, et al. Physical activity and COVID-19: an observational and Mendelian randomisation study. J Glob Health. 2020;10(2). doi:10.7189/jogh-10-020514. PMID: 33312507; PMCID: PMC7719276.
- White RL, Babic MJ, Parker PD, Lubans DR, Astell-Burt T, Lonsdale C. Domain-specific physical activity and mental health: a meta-analysis. Am J Prev Med. 2017;52(5):653-66. doi:1016/j.amepre.2016.12.008. PMID: 28153647.
- Jakobsson J, Malm C, Furberg M, Ekelund U, Svensson M. Physical activity during the coronavirus (COVID-19) pandemic: prevention of a decline in metabolic and immunological functions. Front Sports Act Living. 2020;2:549731. doi:3389/fspor.2020.00057. PMID: 33345048; PMCID: PMC7739799.
- Testino G. Are patients with alcohol use disorders at increased risk for Covid-19 infection? Alcohol and Alcoholism. 2020;55(4):344-6. doi:10.1093/alcalc/agaa037. PMID: 32400858.
- Hamer M, Kivimäki M, Gale CR, Batty GD. Lifestyle risk factors, inflammatory mechanisms, and COVID-19 hospitalization: A community-based cohort study of 387,109 adults in UK. Brain Behav Immun. 2020;87:184-7. doi:10.1016/j.bbi.2020.05.059. PMID: 32454138; PMCID: PMC7245300.
- Li S, Hua X. Modifiable lifestyle factors and severe COVID-19 risk: a Mendelian randomisation study. BMC Med Genomics. 2021;14(1):1-8. doi:10.1186/s12920-021-00887-1. PMID: 33536004; PMCID: PMC7856619.
- Molina PE, Happel KI, Zhang P, Kolls JK, Nelson S. Focus on: alcohol and the immune system. Alcohol Res Health. 2010;33(1-2):97. PMID: 23579940; PMCID: PMC3887500.
- Szabo G, Saha B. Alcohol’s effect on host defense. Alcohol Res. 2015;37(2):159. PMID: 26695755.
- Achur RN, Freeman WM, Vrana KE. Circulating cytokines as biomarkers of alcohol abuse and alcoholism. J Neuroimmune Pharmacol. 2010;5(1):83-91. doi:10.1007/s11481-009-9185-z. PMID: 20020329.
- Parri N, Magistà AM, Marchetti F, Cantoni B, Arrighini A, Romanengo M, et al. Characteristic of COVID-19 infection in pediatric patients: early findings from two Italian Pediatric Research Networks. Eur J Pediatr. 2020;179(8):1315-23. doi:10.1007/s00431-020-03683-8.
- Casillo GM, Mansour AA, Raucci F, Saviano A, Mascolo N, Iqbal AJ, Maione F. Could IL-17 represent a new therapeutic target for the treatment and/or management of COVID-19-related respiratory syndrome? Pharmacological research. 2020;156:104791. doi:10.1016/j.phrs.2020.104791. PMC7194796. PMID: 32302707.
- Li X, Ma X. Acute respiratory failure in COVID-19: is it “typical” ARDS? Critical care. 2020;24(1):198. doi:10.1186/s13054-020-02911-9. PMID: 32375845; PMCID: PMC7202792.
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