Background: Evidence of socioeconomic inequality in COVID-19-related outcomes is emerging, with a higher risk of infection and mortality observed among individuals with lower education attainment. We aimed to evaluate the potential interventions against COVID-19 from the socioeconomic perspective, including improvement in education and intelligence. Methods: With a two-sample Mendelian randomization approach using summary statistics from the largest genome-wide association meta-analysis, univariable analysis was adopted to evaluate the total causal effects of genetically determined education attainment and intelligence on COVID-19 outcomes. Multivariable analysis was performed to dissect the potential mechanisms. Results: Genetic predisposition to higher education attainment by 1 SD (4.2 years) was independently associated with reduced risk of COVID-19 severity (OR = 0.508 [95% CI: 0.417–0.617]; p < 0.001). Genetically higher education attainment also lowered the risk of COVID-19 hospitalization (0.685 [0.593–0.791]; p < 0.001), but the association was attenuated after adjustment for beta estimates of intelligence in multivariable analysis. Genetically higher intelligence was associated with reduced risk of COVID-19 hospitalization (0.780 [0.655–0.930]; p = 0.006), with attenuation of association after adjustment for education attainment. Null association was observed for genetically determined education attainment and intelligence with SARS-CoV-2 infection. Conclusion: Education may act independently and jointly with intelligence in improving the COVID-19 outcomes. Improving education may potentially alleviate the COVID-19-related health inequality.
【저자키워드】 COVID-19, SARS-CoV-2, mendelian randomization, education, intelligence, 【초록키워드】 Meta-analysis, Mortality, Hospitalization, SARS-COV-2 infection, Infection, COVID-19 severity, Intervention, outcome, outcomes, Health, COVID-19 hospitalization, estimate, association, Analysis, evidence of, higher risk, reduced risk, Perspective, individual, multivariable analysis, potential mechanisms, predisposition, genome-wide association, univariable analysis, Effect, approach, risk of COVID-19, evaluate, was performed, adopted, dissect, alleviate, Improving, 【제목키워드】 attainment,