While social isolation and the perception of health risks during the Covid 19 pandemic have been identified as causes of distress, other variables have received little attention. Aim of this study was to explore the risk of COVID infection associated with shift work and occupation. The COVISTRESS online survey was conducted in several European countries during 2020, the first year of the pandemic. Italian participants were 545, 435 of whom (80%) responded to the questions.

From the list of 290 variables, we selected those related to the occupation, sleep quality, shift work, and a set of covariates that might have acted as confounders (age, gender, education, marital status, smoking, physical activity in the leisure time). Sleep quality was self-defined by participants on a scale from 0 to 100. For the purposes of analysis, we used the cut-off of the median value to categorize bad quality (score ? 50) from good quality (score ? 51) sleep. Mean age of participants was 47 years (standard deviation [sd] 11.3), substantially similar by gender (men 46 yrs, sd 12.7; women 47 yrs, sd 10.9), mainly females (76%), with high education level (graduate:  65%), and married (60%). Most had some level of physical activity in the leisure time (82%). We observed a four-fold excess risk of COVID among shift workers (OR = 4.4, 95% CI 2.58, 7.56). Among the occupations reported by study participants, medical doctors (OR = 2.4, 95%CI 1.03 ? 5.59) and nurses (OR = 2.5, 95% CI 1.30 ? 4.80) but not teachers (there were no COVID-19 cases among the 46 participating teachers) run an increased risk. Education level, marital status, smoking, and sleep quality did not account for the association with shift work.