Associations between lifestyle factors and COVID-19 infection rates: a cross-sectional analysis in the USA

The COVID-19 pandemic has underscored the vital connection between lifestyle factors and health outcomes, highlighting the need to understand how lifestyle choices influence both chronic and infectious diseases. Despite known links between lifestyle factors and chronic diseases, the relationship between these factors and infectious diseases like COVID-19 warrants further investigation.This cross-sectional study used an anonymous survey collected from a diverse sample of US residents aged 18 or older. Excluding individuals under 18 or residing outside the USA, the survey captured data on diet, body mass index, smoking status, alcohol consumption, physical activity, sleep duration, COVID-19 infection status, socio-demographics and other potential confounders. Statistical analysis was performed using χ2tests and logistic regression to explore the associations between lifestyle factors and COVID-19 infection, with a particular focus on gender differences.Among 1032 participants, the prevalence of COVID-19 was higher in women (42.8%) compared with men (32.0%). Significant associations were found between inadequate sleep (less than 4 hours per day) and increased risk of COVID-19 in both genders (OR=2.89, 95% CI: 1.13 to 7.35, p=0.02 for men; OR=5.69, 95% CI: 3.14 to 10.29, p<0.00 for women). Additionally, a significant association was observed between a lifestyle index, incorporating multiple lifestyle factors and COVID-19 infection in women (OR=1.79, 95% CI: 1.05 to 3.025, p=0.03).The findings indicate a potential link between lifestyle factors and susceptibility to COVID-19, with inadequate sleep identified as a significant risk factor. These results suggest that promoting a healthy lifestyle could be an effective strategy for controlling the pandemic and mitigating the impact of infectious diseases. Further research is recommended to explore the role of restful sleep in preventing COVID-19 for men and women (including multiple lifestyle factors among women).