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Diet quality and risk and severity of COVID-19: a prospective cohort study
Jordi Merino; Amit D Joshi; Long Nguyen; Emily Leeming; David Alden Drew; Rachel Gibson; Mark S Graham; Mohsen Mazidi; Chun-Han Lo; Joan Capdevila; Ben Murray; christina hu; Somesh Selvachandran; Sohee Kwon; Wenjie MA; Cristina Menni; Alexander Hammers; Shilpa Bhupathiraju; Shreela Sharma; Carole Sudre; Christina M Astley; Walter Willett; Jorge Chavarro; Seb Ourselin; Claire Steves; Jonathan Wolf; Paul W Franks; Timothy Spector; Sarah Berry; Andrew T Chan.
  • Jordi Merino; Massachusetts General Hospital
  • Amit D Joshi; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School
  • Long Nguyen; Massachusetts General Hospital and Harvard Medical School
  • Emily Leeming; King's College London
  • David Alden Drew; Massachusetts General Hospital
  • Rachel Gibson; KCL
  • Mark S Graham; King's College London
  • Mohsen Mazidi; King's College London
  • Chun-Han Lo; Massachusetts General Hospital
  • Joan Capdevila; ZOE
  • Ben Murray; KCL
  • christina hu; ZOE
  • Somesh Selvachandran; ZOE
  • Sohee Kwon; Massachusetts General Hospital
  • Wenjie MA; Massachusetts General Hospital
  • Cristina Menni; King's College London
  • Alexander Hammers; KCL
  • Shilpa Bhupathiraju; Harvard School of Public Health
  • Shreela Sharma; UTHealth
  • Carole Sudre; King's College London
  • Christina M Astley; Boston Children's Hospital
  • Walter Willett; Harvard T.H. Chan School of Public Health
  • Jorge Chavarro; Harvard T.H. Chan School of Public Health
  • Seb Ourselin; King's College London
  • Claire Steves; King's College London
  • Jonathan Wolf; ZOE
  • Paul W Franks; Lund University
  • Timothy Spector; King's College London
  • Sarah Berry; King's College London
  • Andrew T Chan; Massachusetts General Hospital
Preprint in English | medRxiv | ID: ppmedrxiv-21259283
ObjectivePoor metabolic health and certain lifestyle factors have been associated with risk and severity of coronavirus disease 2019 (COVID-19), but data for diet are lacking. We aimed to investigate the association of diet quality with risk and severity of COVID-19 and its intersection with socioeconomic deprivation. DesignWe used data from 592,571 participants of the smartphone-based COVID Symptom Study. Diet quality was assessed using a healthful plant-based diet score, which emphasizes healthy plant foods such as fruits or vegetables. Multivariable Cox models were fitted to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) for COVID-19 risk and severity defined using a validated symptom-based algorithm or hospitalization with oxygen support, respectively. ResultsOver 3,886,274 person-months of follow-up, 31,815 COVID-19 cases were documented. Compared with individuals in the lowest quartile of the diet score, high diet quality was associated with lower risk of COVID-19 (HR, 0.91; 95% CI, 0.88-0.94) and severe COVID-19 (HR, 0.59; 95% CI, 0.47-0.74). The joint association of low diet quality and increased deprivation on COVID-19 risk was higher than the sum of the risk associated with each factor alone (Pinteraction=0.005). The corresponding absolute excess rate for lowest vs highest quartile of diet score was 22.5 (95% CI, 18.8-26.3) and 40.8 (95% CI, 31.7-49.8; 10,000 person-months) among persons living in areas with low and high deprivation, respectively. ConclusionsA dietary pattern characterized by healthy plant-based foods was associated with lower risk and severity of COVID-19. These association may be particularly evident among individuals living in areas with higher socioeconomic deprivation.
Full text: Available Collection: Preprints Database: medRxiv Document Type: Preprint Language: English Year: 2021





Full text: Available Collection: Preprints Database: medRxiv Document Type: Preprint Language: English Year: 2021