Mumbai mayhem of COVID-19 pandemic reveals important factors that influence susceptibility to infection

BACKGROUND: COVID-19 severity is disproportionately high in the elderly and people with comorbidities. However, other factors that predispose individuals to increased chances of infection are unclear. METHODS: Data from 18,600 people screened for COVID-19 in Mumbai during the outbreak's initial phase, March 7 to June 30, 2020, were used to assess risk factors associated with COVID-19 using the odds ratio analysis. FINDINGS: Males aged ≥60 years having both diabetes and hypertension were at the highest risk of COVID-19 infection (M vs. F OR=2.5, 95% CI=1.34–4.67, p = 0.0049). People having both diabetes and 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 had significantly higher risk of COVID-19 infection than those without comorbidity. Quarantined people had significantly lower positive odds (OR=0.59, 95% CI=0.53–0.66, p <0.001) than non-quarantined people. INTERPRETATION: Our research indicates that the risk of getting COVID-19 disease is not equal. When considering sex, age, and comorbidity together, we found that males aged ≥60 years and having both diabetes and hypertension had a significantly high risk of COVID-19 infection. Therefore, remedial measures such as vaccination programs should be prioritized for at-risk individuals. FUNDING: SERB, India: SB/S1/COVID-2/2020 and Seed grant RD/0520-IRCCHC0–006 from IRCC, IIT Bombay.