PT - JOURNAL ARTICLE AU - Jennifer M McKinley AU - David Cutting AU - Neil Anderson AU - Conor Graham AU - Brian Johnston AU - Ute Mueller AU - Peter M Atkinson AU - Hugo Van Woerden AU - Declan T Bradley AU - Frank Kee TI - Association between community-based self-reported COVID-19 symptoms and social deprivation explored using symptom tracker apps: a repeated cross-sectional study in Northern Ireland AID - 10.1136/bmjopen-2020-048333 DP - 2021 Jun 01 TA - BMJ Open PG - e048333 VI - 11 IP - 6 4099 - http://bmjopen.bmj.com/content/11/6/e048333.short 4100 - http://bmjopen.bmj.com/content/11/6/e048333.full SO - BMJ Open2021 Jun 01; 11 AB - Objectives The aim of the study was to investigate the spatial and temporal relationships between the prevalence of COVID-19 symptoms in the community-level and area-level social deprivation.Design Spatial mapping, generalised linear models, using time as a factor and spatial-lag models were used to explore the relationship between self-reported COVID-19 symptom prevalence as recorded through two smartphone symptom tracker apps and a range of socioeconomic factors using a repeated cross-sectional study design.Setting In the community in Northern Ireland, UK. The analysis period included the earliest stages of non-pharmaceutical interventions and societal restrictions or ‘lockdown’ in 2020.Participants Users of two smartphone symptom tracker apps recording self-reported health information who recorded their location as Northern Ireland, UK.Primary outcome measures Population standardised self-reported COVID-19 symptoms and correlation between population standardised self-reported COVID-19 symptoms and area-level characteristics from measures of multiple deprivation including employment levels and population housing density, derived as the mean number of residents per household for each census super output area.Results Higher self-reported prevalence of COVID-19 symptoms was associated with the most deprived areas (p<0.001) and with those areas with the lowest employment levels (p<0.001). Higher rates of self-reported COVID-19 symptoms within the age groups, 18–24 and 25–34 years were found within the most deprived areas during the earliest stages of non-pharmaceutical interventions and societal restrictions (‘lockdown’).Conclusions Through spatial regression of self-reporting COVID-19 smartphone data in the community, this research shows how a lens of social deprivation can deepen our understanding of COVID-19 transmission and prevention. Our findings indicate that social inequality, as measured by area-level deprivation, is associated with disparities in potential COVID-19 infection, with higher prevalence of self-reported COVID-19 symptoms in urban areas associated with area-level social deprivation, housing density and age.Data may be obtained from a third party and are not publicly available. This work uses non-identifiable data provided through use of the DoH NI app, COVIDCare NI (formerly known as ‘COVID-19 NI’). Data may be obtained from the data controllers and are not publicly available. The app was produced on behalf of the DoH by Digital Health and Care Northern Ireland (DHCNI), working partnership with commercial partners Civica and BigMotive). Data may be obtained from the data controllers and are not publicly available.This work also uses data provided by participants of the COVID-19 Symptoms Study, developed by ZOE Global Limited with scientific and clinical input from King’s College London. This study makes use of anonymised data held in the Secure Anonymised Information Linkage (SAIL) Databank. Data may be obtained from the data controllers by application through https://www.healthdatagateway.org.