Socio-economic determinants of SARS-CoV-2 infection: Results from a population-based cross-sectional serosurvey in Geneva, Switzerland

  1. Hugo-Alejandro Santa-Ramírez
  2. Ania Wisniak
  3. Nick Pullen
  4. María-Eugenia Zaballa
  5. Francesco Pennacchio
  6. Elsa Lorthe
  7. Roxane Dumont
  8. Hélène Baysson
  9. Idris Guessous
  10. Silvia Stringhini

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Abstract

SARS-CoV-2 infection and its health consequences have disproportionally affected disadvantaged socio-economic groups globally. This study aimed to analyze the association between socio-economic conditions and having developed antibodies for-SARS-CoV-2 in a population-based sample in the canton of Geneva, Switzerland.

Methods

Data was obtained from a population-based serosurvey of adults in Geneva and their household members, between November and December, 2020, toward the end of the second pandemic wave in the canton. Participants were tested for antibodies for-SARS-CoV-2. Socio-economic conditions representing different dimensions were self-reported. Mixed effects logistic regressions were conducted for each predictor to test its association with seropositive status as the main outcome.

Results

Two thousand eight hundred and eighty-nine adults completed the study questionnaire and were included in the final analysis. Retired participants and those living in suburban areas had lower odds of a seropositive result when compared to employed participants (OR: 0.42, 95% CI: 0.20–0.87) and those living in urban areas (OR: 0.67, 95% CI: 0.46–0.97), respectively. People facing financial hardship for less than a year had higher odds of a seropositive result compared to those who had never faced them (OR: 2.23, 95% CI: 1.01–4.95). Educational level, occupational position, and household income were not associated with being seropositive, nor were ethnicity or country of birth.

Discussion

While conventional measures of socio-economic position did not seem to be related to the risk of being infected in this sample, this study sheds lights on the importance of examining the broader social determinants of health when evaluating the differential impact of the pandemic within the population.

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  1. Version published to 10.3389/fpubh.2022.874252
  2. ScreenIT

    SciScore for 10.1101/2022.05.09.22274838: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: The study was approved by the Geneva Cantonal Commission for Research Ethics (Project N° 2020-00881).
    Consent: All participants provided informed written consent.
    Sex as a biological variableAnalyses were conducted in the overall population and stratified by sex, as a differential risk for COVID-19 outcomes and SARS-CoV-2 infection have been documented between men and women (19) (Annex III and IV.
    RandomizationThe study sample included adults aged 18 years and older, who were randomly selected from a previous population-based serosurvey conducted in the canton of Geneva in spring 2020, and from population registries of the canton.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analyses were conducted using STATA version 14.0 (StataCorp, College Station, TX, USA).
    STATA
    suggested: (Stata, RRID:SCR_012763)
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study also has some limitations. A selection bias should not be disregarded, with people with higher health concerns being more prone to participate, and those most socioeconomically disadvantaged less likely to be included, limiting the generalizability of our results. In addition, the population that was hospitalized at the time of the study or that died because of COVID-19 could not be included in the study, therefore potentially masking the association between socio-economic conditions and SARS-CoV-2 seropositivity for severe cases. As other studies have documented, the severity of the disease might be higher in socioeconomically disadvantaged groups (4,28). The COVID-19 pandemic has disproportionately affected socially vulnerable populations globally. However the impact of socio-economic determinants can vary widely depending on geographical, political and cultural contexts (29–31). In our study we have found associations of employment status, financial hardship and residential area with the natural development of anti SARS-CoV-2 antibodies during the second wave of the pandemic (before the roll-out of the vaccination campaign in Switzerland); but not with other socioeconomic conditions. Our results highlight the importance of examining the broader social determinants of health when evaluating the differential impact of the pandemic within the population. A better understanding of the structural determinants shaping the inequitable distribution of COVID-19 among the ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2022.05.09.22274838v1 on medRxiv