ABSTRACT
COVID-19 has had a substantial impact on clinical care and lifestyles globally. The State of Michigan reports over 80,000 positive COVID-19 tests between March 1, 2020 and July 29, 2020. We surveyed 8,047 Michigan Medicine biorepository participants in late June 2020. We found that 58% of COVID-19 cases reported no known exposure to family members or to someone outside the house diagnosed with COVID-19. A significantly higher rate of COVID-19 cases were employed as essential workers (45% vs 19%, p=3×10-11). COVID-19 cases reporting a fever were more likely to require hospitalization (categorized as severe; OR = 4.6 [95% CI: 1.7-13.0, p=0.004]) whereas respondents reporting rhinorrhea was less likely to require hospitalization (categorized as mild-to-moderate; OR = 0.16 [95% CI: 0.04-0.70, p=0.016]). African-Americans reported higher rates of being diagnosed with COVID-19 (OR = 4.0 [95% CI: 2.2-7.2, p=1×10-4]), as well as higher rates of exposure to family or someone outside the household diagnosed with COVID-19, an annual household income < $40,000, living in rental housing, and chronic diseases. During the Executive Order in Michigan, African Americans, women, and the lowest income group reported worsening health behaviors and higher overall concern for the potential detrimental effects of the pandemic. The higher risk of contracting COVID-19 observed among African Americans may be due to the increased rates of working as essential employees, lower socioeconomic status, and exposure to known positive cases. Continued efforts should focus on COVID-19 prevention and mitigation strategies, as well as address the inequality gaps that result in higher risks for both short-term and long-term health outcomes.
Competing Interest Statement
The spouse of Dr. Willer works for Regeneron Pharmaceuticals Inc. Dr. Brummett is a consultant for Heron Therapeutics and Alosa Health -- not related to the present study.
Funding Statement
Dr. Willer is supported by National Institutes of Health grants R35-HL135824, R01-HL142023, R01-DK075787, and R01-HL109946 Dr. Douville is supported by the Foundation for Anesthesia Education and Research (FAER) - Mentored Research Training Grant.
Author Declarations
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
University of Michigan MED-IRB (HUM00180827)
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Yes
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Data Availability
Data is available from the Data Office at the University of Michigan for IRB approved investigators.