Mumbai Mayhem of COVID-19 Pandemic Reveals Unique Factors that Influence Susceptibility to Infection

Background: COVID-19 disproportionately affects persons of age or with comorbidities. However, whether there are factors that predispose individuals to increased chances of infection are not known.Methods: Data from18600 patients screened for COVID-19 in Mumbai during the outbreak’s initial phase, Apr 1 to Jun 30, 2020, was used to assess risk factors associated with COVID-19 using the odds ratio analysis. Findings: Males aged 60+ years having diabetes-hypertension are at most-risk of COVID-19 infection (M vs. F OR=2.5, 95% CI=1.34 – 4.67, p=0.0049). Patients having diabetes-hypertension in 20+ years (OR=4.11, 95% CI=3.26 – 5.20, p<0.0001), diabetes and hypertension independently in 20-39 (OR=4.13, 95% CI=2.22 – 7.70, p<0.0001, OR=4.32, 95% CI=2.10 – 8.88, p=0.0001) and 60+ years (OR=2.69, 95% CI=1.87 – 3.87, p<0.0001, OR=2.03, 95% CI=1.46 – 2.82, p<0.0001), chronic renal disease in 20-39 years (OR=5.38, 95% CI=1.91 – 15.09, p=0.0007) age groups have significantly higher risk of COVID-19 infection than those without comorbidity. Healthcare workers are significantly less likely than non-healthcare workers to contract infection (OR=0.37, 95% CI=0.32 – 0.43, p<0.001). Quarantined patients have significantly lower positive odds (OR=0.59, 95% CI=0.53 – 0.66, p<0.001) than non-quarantined patients.Interpretation: Our research assesses the risk of getting COVID-19 disease is not equal. When considering sex, age, and comorbidity together, we found that males aged 60+ and having diabetes-hypertension are identified as the only group with significantly high (for this age group and medical condition, M vs. F: OR=2.5, 95% CI=1.34–4.67, p=0.0049) risk of COVID-19 infection. Thus remedial measures such as vaccination programs need to be implemented with the at-risk individuals on priority.Funding Statement: Science and Engineering Research Board (SERB), Government of India (SB/S1/Covid-2/2020), and a seed grant RD/0520-IRCCHC0-006 from IRCC, IIT Bombay to SS.Declaration of Interests: The authors declare that there is no conflict of interest.Ethics Approval Statement: The Institutional Review Board of Kasturba Hospital for Infectious Diseases, Mumbai, approved the use of the data for secondary analysis.