The Importance of Behavioral and Native Factors on COVID-19 Infection and Severity: Insights from a Preliminary Cross-Sectional Study

  1. Hani Amir Aouissi
  2. Mohamed Seif Allah Kechebar
  3. Mostefa Ababsa
  4. Rabih Roufayel
  5. Bilel Neji
  6. Alexandru-Ionut Petrisor
  7. Ahmed Hamimes
  8. Loïc Epelboin
  9. Norio Ohmagari

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Abstract

The COVID-19 pandemic has had a major impact on a global scale. Understanding the innate and lifestyle-related factors influencing the rate and severity of COVID-19 is important for making evidence-based recommendations. This cross-sectional study aims at establishing a potential relationship between human characteristics and vulnerability/resistance to SARS-CoV-2. We hypothesize that the impact of the virus is not the same due to cultural and ethnic differences. A cross-sectional study was performed using an online questionnaire. The methodology included the development of a multi-language survey, expert evaluation, and data analysis. Data were collected using a 13-item pre-tested questionnaire based on a literature review between 9 December 2020 and 21 July 2021. Data were statistically analyzed using logistic regression. For a total of 1125 respondents, 332 (29.5%) were COVID-19 positive; among them, 130 (11.5%) required home-based treatment, and 14 (1.2%) intensive care. The significant and most influential factors on infection included age, physical activity, and health status (p < 0.05), i.e., better physical activity and better health status significantly reduced the possibility of infection, while older age significantly increased it. The severity of infection was negatively associated with the acceptance (adherence and respect) of preventive measures and positively associated with tobacco (p < 0.05), i.e., smoking regularly significantly increases the severity of COVID-19 infection. This suggests the importance of behavioral factors compared to innate ones. Apparently, individual behavior is mainly responsible for the spread of the virus. Therefore, adopting a healthy lifestyle and scrupulously observing preventive measures, including vaccination, would greatly limit the probability of infection and prevent the development of severe COVID-19.

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  1. Version published to 10.3390/healthcare10071341
  2. ScreenIT

    SciScore for 10.1101/2022.01.23.22269214: (What is this?)

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

    Table 1: Rigor

    EthicsConsent: Conventionally, the ethical approval and consent were obtained from the CRSTRA and all participants.
    Sex as a biological variable= Other, 2=African / Afro-American, 3= Caucasian, 4= Arabic, 5= Asian, 6= Latino) - Gender (0=Not precise, 1= Male, 2= Female, 3= Other).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analysis: Statistical analyses were performed using SAS® (version 9.4).
    SAS®
    suggested: (SASqPCR, RRID:SCR_003056)

    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:
    4.3 Methodological limitations: Our analysis was limited to a number of factors considered as relevant based on the literature review, and which could be ascertained using an online questionnaire. However, different studies also pointed out a number of other potential risk factors. Objectively, it is an almost impossible challenge to know exactly the factors responsible for infection and transmission of COVID-19. Sources may be incomplete; apart from the factors discussed previously, even the meteorological ones were considered a potential explanation [164]. A study in Korea demonstrated that the environment plays a significant role in the spread of COVID-19, but like any factor, it may have also been impacted by various additional features [165]. Hence, further studies are needed to protect people from COVID-19 transmission, specifically on infection dynamics and the mode of transmission, e.g., cluster spaces, closed spaces, and indoor environments [166]. At the individual level, everyone must take the maximum possible precautions. It should also be remembered that no less than 10 reasons supporting airborne transmission were phrased recently by Greenhalgh et al. [167]. The long-term health consequences of COVID-19 remain unclear and continue to be studied [168]. Therefore, it is preferable to avoid any form of infection, even mild. Another factor that we do not necessarily think about and which may be important is the wastewater treatment and disinfection strategies with ch...

    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.
    • No funding statement was detected.
    • No protocol registration statement was detected.

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

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  3. Version published to 10.1101/2022.01.23.22269214v1 on medRxiv