{"doi":"10.1101/2020.05.09.20096438","title":"Lifestyle Risk Factors for Cardiovascular Disease in Relation to COVID-19 Hospitalization: A Community-Based Cohort Study of 387,109 Adults in UK","abstract":"Aims: It is important to identify characteristics of people who may be most at risk of COVID-19 to inform policy and intervention. Little is known about the impact of unhealthy lifestyles including smoking, physical inactivity, obesity, and excessive alcohol intake. We conducted the first large-scale general population study on lifestyle risk factors for COVID-19. Methods: Prospective cohort study with national registry linkage to hospitalisation for COVID-19. Participants were 387,109 men and women (56.4 ±8.8 yr; 55.1% women) residing in England from UK Biobank study. Physical activity, smoking, and alcohol intake, were assessed by questionnaire at baseline (2006-2010). Body mass index, from measured height and weight, was used as an indicator of overall obesity. Outcome was cases of COVID-19 serious enough to warrant a hospital admission from 16-March-2020 to 26-April-2020. Results: There were 760 COVID-19 cases. After adjustment for age, sex and mutually for each lifestyle factor, physical inactivity (Relative risk, 1.32, 95% confidence interval, 1.10, 1.58), smoking (1.42;1.12, 1.79) and obesity (2.05 ;1.68, 2.49) but not heavy alcohol consumption (1.12; 0.93, 1.35) were all related to COVID-19. We also found a dose-dependent increase in risk of COVID-19 with less favourable lifestyle scores, such that participants in the most adverse category had 4-fold higher risk (4.41; 2.52 - 7.71) compared to people with the most optimal lifestyle. This gradient was little affected after adjustment for a wide range of covariates. Based on UK risk factor prevalence estimates, unhealthy behaviours in combination accounted for up to 51% of the population attributable fraction of severe COVID-19. Conclusions and Relevance: Our findings suggest that an unhealthy lifestyle synonymous with an elevated risk of non-communicable disease is also a risk factor for COVID-19 hospital admission, accounting for up to half of severe cases. Adopting simple lifestyle changes could lower the risk of severe infection.","journal":"medRxiv","year":2020,"id":118563,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":59,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9535,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":108675,"name":"Mika Kivimäki","orcid":"0000-0002-4699-5627","position":1,"is_corresponding":false},{"id":109449,"name":"Catharine R. Galé","orcid":"0000-0002-3361-8638","position":2,"is_corresponding":false},{"id":108676,"name":"G. David Batty","orcid":"0000-0003-1822-5753","position":3,"is_corresponding":false},{"id":110375,"name":"Mark Hamer","orcid":"0000-0002-8726-7992","position":0,"is_corresponding":true}],"reference_count":12,"raw_metadata":null,"created_at":"2026-07-18T23:13:58.531532Z","pmid":"32511498","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}