Background Evidence regarding the risk of coronavirus disease (COVID-19) and the major adverse clinical outcomes of COVID-19 among people with disabilities (PwDs) is scarce. Objective This study investigated the association of disability status with the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test positivity and the risk of major adverse clinical outcomes among participants who tested positive for SARS-CoV-2. Methods This study included all patients (n = 8,070) who tested positive for SARS-CoV-2 and individuals without COVID-19 (n = 121,050) in South Korea from January 1 to May 30, 2020. The study variables included officially registered disability status from the government, SARS-CoV-2 test positivity, and major adverse clinical outcomes of COVID-19 (admission to the intensive care unit, invasive ventilation, or death). Results The study participants included 129,120 individuals (including 7,261 PwDs), of whom 8,070 (6.3%) tested positive for SARS-CoV-2. After adjusting for potential confounding factors, PwDs had an increased risk of SARS-CoV-2 test positivity compared with people without disabilities (odds ratio [OR]: 1.36, 95% confidence interval [CI]: 1.24–1.48). Among participants who tested positive for SARS-CoV-2, PwDs were associated with an increased risk of major adverse clinical outcomes from COVID-19 compared to those without disabilities (OR: 1.43, 95% CI: 1.11–1.86). Conclusions PwDs had an increased risk of COVID-19 and major adverse clinical outcomes of COVID-19 compared with people without disabilities. Given the higher vulnerability of PwDs to COVID-19, tailored policy and management to protect against the risk of COVID-19 are required.

We investigated the association of changes in the frequency of moderate-to-vigorous physical activity (MVPA) and the risks of all-cause and cardiovascular disease (CVD) mortality. This study used the nationally representative National Health Insurance Service-National Sample Cohort database. We included 286,402 individuals aged ≥20 years and estimated changes in the frequency of MVPA over a two-year period. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard regression models. The HRs (95% CIs) for the risk of all-cause and CVD mortality for an increased frequency of MVPA from physical inactivity compared with continual physical inactivity were 0.82 and 0.68 (0.73–0.92 and 0.51–0.91) for 1–2, 0.72 and 0.48 (0.62–0.84 and 0.31–0.74) for 3–4, and 0.73 and 0.70 (0.63–0.85 and 0.50–0.98) for ≥5 sessions of MVPA/week. The HRs (95% CIs) for the risk of all-cause and CVD mortality were 1.28 and 1.58 (1.07–1.53 and 1.01–2.46), 1.25 and 2.17 (1.01–1.57 and 1.14–4.12), and 1.43 and 1.44 (1.15–1.77 and 0.84–2.47) for changes from 1–2, 3–4, and ≥5 sessions of MVPA/week to physical inactivity, respectively. This study showed the beneficial effect of increasing physical activity, particularly for those who were physically inactive at baseline, as well as the increased risk of all-cause and CVD mortality after adapting a physically inactive lifestyle regardless of their baseline physical activity status.

INTRODUCTION This study examined the association between smoking status and death from COVID-19. METHODS This study used nationwide cohort data collected from the Korean National Health Insurance Service, linking to information on all individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The smoking status of subjects who participated twice in national health screenings between 2015 and 2018 was measured. This study investigated death from COVID-19 among those who tested positive from 1 January to 30 May 2020. RESULTS This study included 4259 patients who tested positive for SARS-CoV-2 in Korea. After adjusting for all potential confounding factors, current smokers (adjusted odds ratio, AOR=3.75; 95% CI: 1.23–11.36) and recent quitters (AOR=3.74; 95% CI: 1.12–12.53) were associated with an increased risk of death from COVID-19 compared to never smokers. Compared with current smokers, long-term quitters (AOR=0.33; 95% CI: 0.11–0.95) and never smokers (AOR=0.27; 95% CI: 0.09–0.81) were associated with a reduced risk of death from COVID-19. CONCLUSIONS Smoking was associated with an increased risk of death among patients with COVID-19. Given the lower possibility of death in long-term quitters with COVID-19, continuous smoking cessation among smokers or recent quitters is needed.

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Little is known about the risk of hypertension and type 2 diabetes in relation to changes in frequency and amount of alcohol consumption. This study investigated associations between changes in alcohol consumption and the risk of both conditions. This study included 96,129 individuals without hypertension and/or diabetes mellitus aged ≥ 20 years between 2006 and 2008, with follow-up until 31 December 2015. This study identified 29,043 and 18,784 incident cases of hypertension and type 2 diabetes, respectively, during an average follow-up period of 6.2 ± 2.6 and 6.9 ± 1.9 years. This study measured changes in frequency and amount of alcohol consumption using standardized self-administered questionnaires over approximately 2 years. Hazard ratio (HR) and 95% confidence interval (CI) were calculated for the respective risks of the two conditions. Repeated occasional or frequent binge drinking was associated with an increased risk of hypertension (HR: 1.16 or 1.32; 95% CI: 1.11, 1.21 or 1.16, 1.51) and type 2 diabetes (HR: 1.14 or 1.36; 95% CI: 1.09, 1.20 or 1.17, 1.58) compared with continuous nondrinking. Reductions as well as increases in frequency of alcohol consumption among binge drinkers were associated with higher hypertension (HR: 1.29 or 1.30; 95% CI: 1.11, 1.49 or 1.13, 1.49) and type 2 diabetes (HR: 1.26 or 1.56; 95% CI: 1.06, 1.49 or 1.34, 1.81) risk. This study demonstrated that repeated binge drinking, even with a reduction of weekly alcohol consumption frequency, was associated with a higher risk of hypertension and type 2 diabetes.