Jobs, Housing and Mask-Wearing: A Cross-Sectional Study of Risk Factors for COVID-19.

Background Many studies have focused on characteristics of symptomatic COVID-19 patients and clinical risk factors. This study reports prevalence of COVID-19 in an asymptomatic population of a hospital service area (HSA) and identifies factors that affect exposure to the virus. Objective To measure the prevalence of COVID-19 in a HSA; identify factors that may increase or decrease the risk of infection; and to analyze factors that increase the number of daily contacts. Methods This study collected survey information from 1,694 patients between April 30th and May 13th, 2020, relating to work and living situations, income, behavior, socio-demographic characteristics and pre-pandemic health characteristics. This data was linked to testing data for 454 of these patients gathered including polymerase chain reaction (PCR) results and two different serologic assays. Positivity rate was used to calculate approximate prevalence, hospitalization rate and infection fatality rate (IFR). Survey data was used to analyze risk factors, including the number of contacts reported by study participants. The data was also used to identify factors increasing the number of daily contacts, such as mask wearing and living environment. Results We found a positivity rate of 2.2 percent, a hospitalization rate of 1.2 percent and an adjusted IFR of 0.55 percent. Number of daily contacts with adults and seniors increases the probability of becoming infected. Occupation, living in apartment versus a house, and wearing a facial mask outside work increased the number of daily contacts. Conclusions Studying the prevalence in an asymptomatic population revealed estimates of unreported COVID-19 cases. Occupational, living-situation, and behavioral data about COVID-19 protective behaviors such as mask wearing may aid in the identification of non-clinical factors affecting the number of daily contacts which may increase SARS-CoV-2 exposure.