Background: In the absence of universal testing, effective therapies, or vaccines, identifying risk factors for viral infection, particularly readily modifiable exposures and behaviors, is required to identify effective strategies against viral infection and transmission. Methods: We conducted a world-wide mobile application-based prospective cohort study available to English speaking adults with a smartphone. We collected self-reported characteristics, exposures, and behaviors, as well as smartphone-based geolocation data. Our main outcome was incident symptoms of viral infection, defined as fevers and chills plus one other symptom previously shown to occur with SARS-CoV-2 infection, determined by daily surveys. Findings: Among 14, 335 participants residing in all 50 US states and 93 different countries followed for a median 21 days (IQR 10-26 days), 424 (3%) developed incident viral symptoms. In pooled multivariable logistic regression models, female biological sex (odds ration [OR] 1.75, 95% CI 1.39-2.20, p<0.001), anemia (OR 1.45, 95% CI 1.16-1.81, p=0.001), hypertension (OR 1.35, 95% CI 1.08-1.68, p=0.007), cigarette smoking in the last 30 days (OR 1.86, 95% CI 1.35-2.55, p<0.001), any viral symptoms among household members 6-12 days prior (OR 2.06, 95% CI 1.67-2.55, p<0.001), and the maximum number of individuals the participant interacted with within 6 feet in the past 6-12 days (OR 1.15, 95% CI 1.06-1.25, p<0.001) were each associated with a higher risk of developing viral symptoms. Conversely, a higher subjective social status (OR 0.87, 95% CI 0.83-0.93, p<0.001), at least weekly exercise (OR 0.57, 95% CI 0.47-0.70, p<0.001), and sanitizing one's phone (OR 0.79, 95% CI 0.63-0.99, p=0.037) were each associated with a lower risk of developing viral symptoms. Interpretation: While several immutable characteristics were associated with the risk of developing viral symptoms, multiple immediately modifiable exposures and habits that influence risk were also observed, potentially identifying readily accessible strategies to mitigate risk in the Covid-19 era.

中文翻译：

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Covid-19时代确定的突发性病毒症状的预测因子

背景：在缺乏通用测试，有效疗法或疫苗的情况下，需要确定病毒感染的危险因素，尤其是容易改变的暴露和行为，以确定有效的策略来对抗病毒感染和传播。方法：我们进行了一项基于全球移动应用的前瞻性队列研究，该研究适用于使用智能手机的讲英语的成年人。我们收集了自我报告的特征，暴露和行为以及基于智能手机的地理位置数据。我们的主要结局是病毒感染的突发症状，定义为发烧，发冷，加上以前显示出的与SARS-CoV-2感染有关的另一种症状，通过每日调查确定。调查结果：在14中 居住在美国所有50个州和93个不同国家/地区的335名参与者进行了平均21天（IQR 10-26天）的随访，其中424名（3％）出现了病毒性症状。在汇总的多变量logistic回归模型中，女性的生物学性别（比值[OR] 1.75，95％CI 1.39-2.20，p <0.001），贫血（OR 1.45，95％CI 1.16-1.81，p = 0.001），高血压（OR 1.35，95％CI 1.08-1.68，p = 0.007），最近30天吸烟（OR 1.86，95％CI 1.35-2.55，p <0.001），家庭成员在6-12天前出现任何病毒性症状（OR 2.06，95％CI 1.67-2.55，p <0.001），以及过去6-12天内参与者与6英尺内互动的最大个体数（OR 1.15，95％CI 1.06-1.25，p <0.001）为每一种都与发生病毒性症状的风险较高有关。相反，主观社会地位较高（OR为0.87，95％CI为0.83-0.93，p <0.001），至少每周进行一次锻炼（OR 0.57，95％CI 0.47-0.70，p <0.001）和对手机进行消毒（OR 0.79，95％CI 0.63-0.99，p = 0.037）均与较低的压力相关。出现病毒性症状的风险。解释：虽然几个不变的特征与病毒性症状发展的风险有关，但也观察到了多种可立即改变的暴露和影响风险的习惯，从而潜在地确定了在Covid-19时代减轻风险的容易获得的策略。