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Marín-Palma D, Tabares-Guevara JH, Zapata-Cardona MI, Zapata-Builes W, Taborda N, Rugeles MT, Hernandez JC. PM10 promotes an inflammatory cytokine response that may impact SARS-CoV-2 replication in vitro. Front Immunol 2023; 14:1161135. [PMID: 37180105 PMCID: PMC10166799 DOI: 10.3389/fimmu.2023.1161135] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023] Open
Abstract
Introduction In the last decades, a decrease in air quality has been observed, mainly associated with anthropogenic activities. Air pollutants, including particulate matter (PM), have been associated with adverse effects on human health, such as exacerbation of respiratory diseases and infections. High levels of PM in the air have recently been associated with increased morbidity and mortality of COVID-19 in some regions of the world. Objective To evaluate the effect of coarse particulate matter (PM10) on the inflammatory response and viral replication triggered by SARS-CoV-2 using in vitro models. Methods Peripheral blood mononuclear cells (PBMC) from healthy donors were treated with PM10 and subsequently exposed to SARS-CoV-2 (D614G strain, MOI 0.1). The production of pro-inflammatory cytokines and antiviral factors was quantified by qPCR and ELISA. In addition, using the A549 cell line, previously exposed to PM, the viral replication was evaluated by qPCR and plaque assay. Results SARS-CoV-2 stimulation increased the production of pro-inflammatory cytokines in PBMC, such as IL-1β, IL-6 and IL-8, but not antiviral factors. Likewise, PM10 induced significant production of IL-6 in PBMCs stimulated with SARS-CoV-2 and decreased the expression of OAS and PKR. Additionally, PM10 induces the release of IL-1β in PBMC exposed to SARS-CoV-2 as well as in a co-culture of epithelial cells and PBMCs. Finally, increased viral replication of SARS-CoV-2 was shown in response to PM10. Conclusion Exposure to coarse particulate matter increases the production of pro-inflammatory cytokines, such as IL-1β and IL-6, and may alter the expression of antiviral factors, which are relevant for the immune response to SARS-CoV-2. These results suggest that pre-exposure to air particulate matter could have a modest role in the higher production of cytokines and viral replication during COVID-19, which eventually could contribute to severe clinical outcomes.
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Affiliation(s)
- Damariz Marín-Palma
- Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Medellín, Colombia
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia (UdeA), Medellín, Colombia
| | - Jorge H. Tabares-Guevara
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia (UdeA), Medellín, Colombia
| | - María I. Zapata-Cardona
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia (UdeA), Medellín, Colombia
| | - Wildeman Zapata-Builes
- Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Medellín, Colombia
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia (UdeA), Medellín, Colombia
| | - Natalia Taborda
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia (UdeA), Medellín, Colombia
- Grupo de Investigaciones Biomédicas Uniremington, Programa de Medicina, Facultad de Ciencias de la Salud, Corporación Universitaria Remington, Medellín, Colombia
| | - Maria T. Rugeles
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia (UdeA), Medellín, Colombia
| | - Juan C. Hernandez
- Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Medellín, Colombia
- Grupo Inmunovirología, Facultad de Medicina, Universidad de Antioquia (UdeA), Medellín, Colombia
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Paget J, Staadegaard L, Wang X, Li Y, van Pomeren T, van Summeren J, Dückers M, Chaves SS, Johnson EK, Mahé C, Nair H, Viboud C, Spreeuwenberg P. Global and national influenza-associated hospitalisation rates: Estimates for 40 countries and administrative regions. J Glob Health 2023; 13:04003. [PMID: 36701368 PMCID: PMC9879557 DOI: 10.7189/jogh.13.04003] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background WHO estimates that seasonal influenza epidemics result in three to five million cases of severe illness (hospitalisations) every year. We aimed to improve the understanding of influenza-associated hospitalisation estimates at a national and global level. Methods We performed a systematic literature review of English- and Chinese-language studies published between 1995 and 2020 estimating influenza-associated hospitalisation. We included a total of 127 studies (seven in Chinese) in the meta-analysis and analyzed their data using a logit-logistic regression model to understand the influence of five study factors and produce national and global estimates by age groups. The five study factors assessed were: 1) the method used to calculate the influenza-associated hospitalisation estimates (rate- or time series regression-based), 2) the outcome measure (divided into three envelopes: narrow, medium, or wide), 3) whether every case was laboratory-confirmed or not, 4) whether the estimates were national or sub-national, 5) whether the rates were based on a single year or multiple years. Results The overall pooled influenza-associated hospitalisation rate was 40.5 (95% confidence interval (CI) = 24.3-67.4) per 100 000 persons, with rates varying substantially by age: 224.0 (95% CI = 118.8-420.0) in children aged 0-4 years and 96.8 (95% CI = 57.0-164.3) in the elderly aged >65 years. The overall pooled hospitalisation rates varied by calculation method; for all ages, the rates were significantly higher when they were based on rate-based methods or calculated on a single season and significantly lower when cases were laboratory-confirmed. The national hospitalisation rates (all ages) varied considerably, ranging from 11.7 (95% CI = 3.8-36.3) per 100 000 in New Zealand to 122.1 (95% CI = 41.5-358.4) per 100 000 in India (all age estimates). Conclusions Using the pooled global influenza-associated hospitalisation rate, we estimate that seasonal influenza epidemics result in 3.2 million cases of severe illness (hospitalisations) per annum. More extensive analyses are required to assess the influence of other factors on the estimates (e.g. vaccination and dominant virus (sub)types) and efforts to harmonize the methods should be encouraged. Our study highlights the high rates of influenza-associated hospitalisations in children aged 0-4 years and the elderly aged 65+ years.
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Affiliation(s)
- John Paget
- Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | - Lisa Staadegaard
- Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | - Xin Wang
- School of Public Health, Nanjing Medical University, Nanjing, China,Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - You Li
- School of Public Health, Nanjing Medical University, Nanjing, China,Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Tayma van Pomeren
- Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | | | - Michel Dückers
- Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
| | - Sandra S Chaves
- Foundation for Influenza Epidemiology, Fondation de France, Paris, France
| | - Emily K Johnson
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Cédric Mahé
- Foundation for Influenza Epidemiology, Fondation de France, Paris, France
| | - Harish Nair
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Cecile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, USA
| | - Peter Spreeuwenberg
- Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
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3
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Wang X, Cai J, Liu X, Wang B, Yan L, Liu R, Nie Y, Wang Y, Zhang X, Zhang X. Impact of PM 2.5 and ozone on incidence of influenza in Shijiazhuang, China: a time-series study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:10426-10443. [PMID: 36076137 PMCID: PMC9458314 DOI: 10.1007/s11356-022-22814-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/27/2022] [Indexed: 05/03/2023]
Abstract
Most of the studies are focused on influenza and meteorological factors for influenza. There are still few studies focused on the relationship between pollution factors and influenza, and the results are not consistent. This study conducted distributed lag nonlinear model and attributable risk on the relationship between influenza and pollution factors, aiming to quantify the association and provide a basis for the prevention of influenza and the formulation of relevant policies. Environmental data in Shijiazhuang from 2014 to 2019, as well as the data on hospital-confirmed influenza, were collected. When the concentration of PM2.5 was the highest (621 μg/m3), the relative risk was the highest (RR: 2.39, 95% CI: 1.10-5.17). For extremely high concentration PM2.5 (348 μg/m3), analysis of cumulative lag effect showed statistical significance from cumulative lag0-1 to lag0-6 day, and the minimum cumulative lag effect appeared in lag0-2 (RR: 0.760, 95% CI: 0.655-0.882). In terms of ozone, the RR value was 2.28(1.19,4.38), when O3 concentration was 310 μg/m3, and the RR was 1.65(1.26,2.15), when O3 concentration was 0 μg/m3. The RR of this lag effect increased with the increase of lag days, and reached the maximum at lag0-7 days, RR and 95% CI of slightly low concentration and extremely high concentration were 1.217(1.108,1.337) and 1.440(1.012,2.047), respectively. Stratified analysis showed that there was little difference in gender, but in different age groups, the cumulative lag effect of these two pollutants on influenza was significantly different. Our study found a non-linear relationship between two pollutants and influenza; slightly low concentrations were more associated with contaminant-related influenza. Health workers should encourage patients to get the influenza vaccine and wear masks when going out during flu seasons.
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Affiliation(s)
- Xue Wang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Jianning Cai
- The Department of Epidemic Treating and Preventing, Center for Disease Prevention and Control of Shijiazhuang City, Shijiazhuang, China
| | - Xuehui Liu
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Binhao Wang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Lina Yan
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Ran Liu
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Yaxiong Nie
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Yameng Wang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Xinzhu Zhang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China
| | - Xiaolin Zhang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, 361 Zhongshan East Road, Shijiazhuang, 050017, China.
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4
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Nuutinen M, Haavisto I, Niemi AJ, Rissanen A, Ikivuo M, Leskelä RL. Statistical model for factors correlating with COVID-19 deaths. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 82:103333. [PMID: 36277812 PMCID: PMC9557215 DOI: 10.1016/j.ijdrr.2022.103333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The COVID-19 pandemic has caused major disruption in societies globally. Our aim is to understand, what factors were associated with the impact of the pandemic on death rates. This will help countries to better prepare for and respond in future pandemics. METHODS We modeled with a linear mixed effect model the impact of COVID-19 with the dependent variable "Daily mortality change" (DMC) with country features variables and intervention (containment measurement) data. We tested both country characteristics consisting of demographic, societal, health related, healthcare system specific, environmental and cultural feature as well as COVID-19 specific response in the form of social distancing interventions. RESULTS A statistically significant country feature was Geert Hofstede's masculinity, i.e., the extent to which the use of force is endorsed socially, correlating positively with a higher DMC. The effects of different interventions were stronger that those of country features, particularly cancelling public events, controlling international travel and closing workplaces. CONCLUSION Social distancing interventions and the country feature: Geert Hofstede's masculinity dimension had a significant impact on COVID-19 mortality change. However other country features, such as development and population health did not show significance. Thus, the crises responders and scholars could revisit the concept and understanding of preparedness for and response to pandemics.
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Affiliation(s)
| | - Ira Haavisto
- NHG Finland and Hanken School of Economics, Finland
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5
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Recent Insights into Particulate Matter (PM 2.5)-Mediated Toxicity in Humans: An Overview. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127511. [PMID: 35742761 PMCID: PMC9223652 DOI: 10.3390/ijerph19127511] [Citation(s) in RCA: 106] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 12/10/2022]
Abstract
Several epidemiologic and toxicological studies have commonly viewed ambient fine particulate matter (PM2.5), defined as particles having an aerodynamic diameter of less than 2.5 µm, as a significant potential danger to human health. PM2.5 is mostly absorbed through the respiratory system, where it can infiltrate the lung alveoli and reach the bloodstream. In the respiratory system, reactive oxygen or nitrogen species (ROS, RNS) and oxidative stress stimulate the generation of mediators of pulmonary inflammation and begin or promote numerous illnesses. According to the most recent data, fine particulate matter, or PM2.5, is responsible for nearly 4 million deaths globally from cardiopulmonary illnesses such as heart disease, respiratory infections, chronic lung disease, cancers, preterm births, and other illnesses. There has been increased worry in recent years about the negative impacts of this worldwide danger. The causal associations between PM2.5 and human health, the toxic effects and potential mechanisms of PM2.5, and molecular pathways have been described in this review.
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6
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Estimates of mortality associated with seasonal influenza for the European Union from the GLaMOR project. Vaccine 2022; 40:1361-1369. [PMID: 35094868 DOI: 10.1016/j.vaccine.2021.11.080] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/30/2021] [Accepted: 11/28/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The European Centres for Disease Prevention and Control (ECDC) estimates that seasonal influenzacauses 4-50 million symptomatic infections in the EU/EEA each year and 15,000-70,000 European citizens die of causes associated with influenza. We used modelling methods to estimate influenza-associated mortality for the European Union by age group and country. METHODS We compiled influenza-associated respiratory mortality estimates for 31 countries around the world (11 countries in the EU) during 2002-2011 (excluding the 2009 pandemic). From these we extrapolated the influenza mortality burden for all 193 countries of the world, including the 28 countries of the EU, using a multiple imputation approach. To study the effect of vaccination programs, we obtained data from the EU-funded VENICE project regarding the percentage of persons over 65 who were vaccinated in each country; the data ranged from 2% to 82% between the 21 countries which provided estimates for the 2006/07 reference season. RESULTS We estimated that an average of 27,600 (range 16,200-39,000) respiratory deaths were associated with seasonal influenza in the 28 EU countries per winter; 88% were among people 65 years and older, and the rates of mortality in this age group were roughly 35 times higher compared with those < 65 years. Estimates varied considerably across the EU; for example, rates in the elderly ranged from 21.6 (12.5-35.1) per 100,000 in Portugal to 36.5 (16.4-62.5) in Luxembourg, a difference of nearly 70%. We were unable to find a negative correlation between vaccination coverage rates and influenza-associated mortality estimates in the elderly. CONCLUSION Our EU estimate of influenza-associated respiratory mortality is broadly consistent with the ECDC estimate. More research is needed to explain the observed variation in mortality across the EU, and on possible bias that could explain the unexpected lack of mortality benefits associated with European elderly influenza vaccination programs.
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7
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Gouda KC, Singh P, P N, Benke M, Kumari R, Agnihotri G, Hungund KM, M C, B KR, V R, S H. Assessment of air pollution status during COVID-19 lockdown (March-May 2020) over Bangalore City in India. ENVIRONMENTAL MONITORING AND ASSESSMENT 2021; 193:395. [PMID: 34105059 PMCID: PMC8186354 DOI: 10.1007/s10661-021-09177-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/31/2021] [Indexed: 05/26/2023]
Abstract
The coronavirus disease 2019 (COVID-19), which became a global pandemic by March 2020, forced almost all countries over the world to impose the lockdown as a measure of social distancing to control the spread of infection. India also strictly implemented a countrywide lockdown, starting from 24 March to 12 May 2020. This measure resulted in the reduction of the sources of air pollution in general: industrial, commercial, and vehicular pollution in particular, with visible improvement in ambient air quality. In this study, the impact of COVID-19 lockdown on the ambient concentration of air pollutants over the city of Bangalore (India) is assessed using Continuous Ambient Air Quality Measurement (CAAQM) data from 10 monitoring stations spread across the city. The data was obtained from Central Pollution Control Board (CPCB) and Karnataka State Pollution Control Board (KSPCB). The analysis of the relative changes in the ambient concentration of six major air pollutants (NO, NO2, NOX, PM2.5, O3, and SO2) has been carried out for two periods: March-May 2020 (COVID-19 lockdown) and the corresponding period of 2019 during when there was no lockdown. The analysis revealed significant reduction in the concentration of ambient air pollutants at both daily and monthly intervals. This can be attributed to the reduction in sources of emission; vehicular traffic, industrial, and other activities. The average reduction in the concentration of NO, NO2, NOX, PM2.5, and O3 between 01 March and 12 May 2020 was found to be 63%, 48%, 48%, 18%, and 23% respectively when compared to the same period in 2019. Similarly, the comparative analysis of pollutant concentrations between pre-lockdown (01-23 March 2020) and lockdown (24 March-12 May 2020) periods has shown a huge reduction in the ambient concentration of air pollutants, 47.3% (NO), 49% (NO2), 49% (NOX), 10% (SO2), 37.7% (PM2.5), and 15.6% (O3), resulting in improved air quality over Bangalore during the COVID-19 lockdown period. It is shown that the strict lockdown resulted in a significant reduction in the pollution levels. Such lockdowns may be useful as emergency intervention strategies to control air pollution in megacities when ambient air quality deteriorates dangerously.
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Affiliation(s)
- K C Gouda
- CSIR Fourth Paradigm Institute, Wind Tunnel Road, Bangalore, India.
| | - Priya Singh
- CSIR Fourth Paradigm Institute, Wind Tunnel Road, Bangalore, India
| | - Nikhilasuma P
- CSIR Fourth Paradigm Institute, Wind Tunnel Road, Bangalore, India
| | - Mahendra Benke
- CSIR Fourth Paradigm Institute, Wind Tunnel Road, Bangalore, India
| | - Reshama Kumari
- CSIR Fourth Paradigm Institute, Wind Tunnel Road, Bangalore, India
| | - Geeta Agnihotri
- Meteorological Centre Bangalore, India Meteorological Department, Bangalore, India
| | - Kiran M Hungund
- Karnataka State Remote Sensing Application Centre, Bangalore, India
| | | | - Kantha Rao B
- CSIR Fourth Paradigm Institute, Wind Tunnel Road, Bangalore, India
| | - Ramesh V
- Karnataka State Pollution Control Board, Bangalore, India
| | - Himesh S
- CSIR Fourth Paradigm Institute, Wind Tunnel Road, Bangalore, India
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8
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Tsopra R, Frappe P, Streit S, Neves AL, Honkoop PJ, Espinosa-Gonzalez AB, Geroğlu B, Jahr T, Lingner H, Nessler K, Pesolillo G, Sivertsen ØS, Thulesius H, Zoitanu R, Burgun A, Kinouani S. Reorganisation of GP surgeries during the COVID-19 outbreak: analysis of guidelines from 15 countries. BMC FAMILY PRACTICE 2021; 22:96. [PMID: 34000985 PMCID: PMC8127252 DOI: 10.1186/s12875-021-01413-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/10/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND General practitioners (GPs) play a key role in managing the COVID-19 outbreak. However, they may encounter difficulties adapting their practices to the pandemic. We provide here an analysis of guidelines for the reorganisation of GP surgeries during the beginning of the pandemic from 15 countries. METHODS A network of GPs collaborated together in a three-step process: (i) identification of key recommendations of GP surgery reorganisation, according to WHO, CDC and health professional resources from health care facilities; (ii) collection of key recommendations included in the guidelines published in 15 countries; (iii) analysis, comparison and synthesis of the results. RESULTS Recommendations for the reorganisation of GP surgeries of four types were identified: (i) reorganisation of GP consultations (cancelation of non-urgent consultations, follow-up via e-consultations), (ii) reorganisation of GP surgeries (area partitioning, visual alerts and signs, strict hygiene measures), (iii) reorganisation of medical examinations by GPs (equipment, hygiene, partial clinical examinations, patient education), (iv) reorganisation of GP staff (equipment, management, meetings, collaboration with the local community). CONCLUSIONS We provide here an analysis of guidelines for the reorganisation of GP surgeries during the beginning of the COVID-19 outbreak from 15 countries. These guidelines focus principally on clinical care, with less attention paid to staff management, and the area of epidemiological surveillance and research is largely neglected. The differences of guidelines between countries and the difficulty to apply them in routine care, highlight the need of advanced research in primary care. Thereby, primary care would be able to provide recommendations adapted to the real-world settings and with stronger evidence, which is especially necessary during pandemics.
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Affiliation(s)
- Rosy Tsopra
- INSERM, Université de Paris, Sorbonne Université, Centre de Recherche des Cordeliers, Information Sciences to support Personalized Medicine, F-75006, Paris, France. .,Department of Medical Informatics, Hôpital Européen Georges-Pompidou, AP-HP, Paris, France.
| | - Paul Frappe
- Department of general practice, Faculty of medicine Jacques Lisfranc, University of Lyon, Saint-Etienne, France.,Inserm UMR 1059, Sainbiose DVH, University of Lyon, Saint-Etienne, France.,Inserm CIC-EC 1408, University of Lyon, Saint-Etienne, France.,College of General Practice / Collège de la Médecine Générale, Paris, France
| | - Sven Streit
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Ana Luisa Neves
- Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK.,Center for Health Technology and Services Research / Department of Community Medicine, Health Information and Decision, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Persijn J Honkoop
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Berk Geroğlu
- İzmir Karşıyaka District Health Directorate, İzmir, Turkey
| | - Tobias Jahr
- Medizinische Hochschule Hannover, OE 5430, Carl Neuberg Str. 1, 30625, Hannover, Germany
| | - Heidrun Lingner
- Medizinische Hochschule Hannover, Medizinische Psychologie, OE 5430, Hannover, Germany.,Member of the German Center for Lung Research (DZL)/ BREATH - Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Carl Neuberg Str. 1, 30625, Hannover, Germany
| | - Katarzyna Nessler
- Department of Family Medicine, Jagiellonian University Medical College, Kraków, Poland.,Vasco da Gama Movement, Wonca Europe, Kraków, Poland
| | | | - Øyvind Stople Sivertsen
- Torshovdalen Health Center, Oslo, Norway.,Editor of the Journal of the Norwegian Medical Association, Oslo, Norway
| | | | - Raluca Zoitanu
- National Federation of Family Medicine Employers in Romania (FNPMF), București, Romania
| | - Anita Burgun
- INSERM, Université de Paris, Sorbonne Université, Centre de Recherche des Cordeliers, Information Sciences to support Personalized Medicine, F-75006, Paris, France.,Department of Medical Informatics, Hôpital Européen Georges-Pompidou & Necker Children's Hospital, AP-HP, Paris, France
| | - Shérazade Kinouani
- INSERM, Bordeaux Population Health Research Center, team HEALTHY, UMR 1219, university of Bordeaux, F-33000, Bordeaux, France.,Department of General Practice, University of Bordeaux, 146 rue Léo Saignat, F-33000, Bordeaux, France
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Flores-Ramírez R, Berumen-Rodríguez AA, Martínez-Castillo MA, Alcántara-Quintana LE, Díaz-Barriga F, Díaz de León-Martínez L. A review of Environmental risks and vulnerability factors of indigenous populations from Latin America and the Caribbean in the face of the COVID-19. Glob Public Health 2021; 16:975-999. [PMID: 33966608 DOI: 10.1080/17441692.2021.1923777] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Latin America and the Caribbean (LAC) was declared a new epicentre of the coronavirus pandemic by the World Health Organization (WHO) on 22 May 2020. As of 13 January 2021, the numbers of deaths and cases caused by COVID-19 in LAC reported are 552,000 and 17'485,000 respectively. LAC concentrates the largest percentage of indigenous populations throughout the world. In this region, poverty is persistent and particularly rural indigenous peoples hold the steepest barriers to health services and experience profound discrimination based on ethnicity, poverty, and language, compared to their non-indigenous counterparts. The information regarding the health of indigenous populations, in general, is scarce, and this problem is aggravated in the face of the COVID-19 pandemic. Therefore, the main objective of this work is to address the overall scenario of indigenous peoples in the Latin American and Caribbean region from March 2020 to January 2021, in this manner gathering information regarding health problems, economic, social, cultural and environmental factors that make indigenous populations in LAC particularly vulnerable to serious health effects from the COVID-19 pandemic, as well as compiling the mitigation strategies implemented in indigenous communities.
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Affiliation(s)
- Rogelio Flores-Ramírez
- CONACYT Research Fellow, Coordinación para la Innovación y Aplicación de la Ciencia y la Tecnología (CIACYT), San Luis Potosí, México
| | | | | | - Luz Eugenia Alcántara-Quintana
- CONACYT Research Fellow, Coordinación para la Innovación y Aplicación de la Ciencia y la Tecnología (CIACYT), San Luis Potosí, México
| | - Fernando Díaz-Barriga
- Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), San Luis Potosí, México
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Hou C, Qin Y, Wang G, Liu Q, Yang X, Wang H. Impact of a long-term air pollution exposure on the case fatality rate of COVID-19 patients-A multicity study. J Med Virol 2021; 93:2938-2946. [PMID: 33470428 PMCID: PMC8014152 DOI: 10.1002/jmv.26807] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 01/04/2021] [Accepted: 01/17/2021] [Indexed: 12/18/2022]
Abstract
Evidence in the literature suggests that air pollution exposure affects outcomes of patients with COVID-19. However, the extent of this effect requires further investigation. This study was designed to investigate the relationship between long-term exposure to air pollution and the case fatality rate (CFR) of patients with COVID-19. The data on air quality index (AQI), PM2.5, PM10, SO2 , NO2 , and O3 from 14 major cities in China in the past 5 years (2015-2020) were collected, and the CRF of COVID-19 patients in these cities was calculated. First, we investigated the correlation between CFR and long-term air quality indicators. Second, we examined the air pollutants affecting CFR and evaluated their predictive values. We found a positive correlation between the CFR and AQI (1, 3, and 5 years), PM2.5 (1, 3, and 5 years), and PM10 (1, 3, and 5 years). Further analysis indicated the more significant correlation for both AQI (3 and 5 years) and PM2.5 (1, 3, and 5 years) with CFR, and moderate predictive values for air pollution indicators such as AQI (1, 3, and 5 years) and PM2.5 (1, 3, and 5 years) for CFR. Our results indicate that long-term exposure to severe air pollution is associated with higher CFR of COVID-19 patients. Air pollutants such as PM2.5 may assist with the prediction of CFR for COVID-19 patients.
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Affiliation(s)
- Chang‐kai Hou
- Department of NeurosurgeryTianjin Medical University General HospitalTianjinChina
| | - Ya‐fei Qin
- Department of General SurgeryTianjin Medical University General HospitalTianjinChina
| | - Grace Wang
- Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Quan‐lei Liu
- Department of NeurosurgeryTianjin Medical University General HospitalTianjinChina
| | - Xin‐yu Yang
- Department of NeurosurgeryTianjin Medical University General HospitalTianjinChina
| | - Hao Wang
- Department of General Surgery, Tianjin General Surgery InstituteTianjin Medical University General HospitalTianjinChina
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11
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Setter NW, Peres ML, de Almeida BMM, Petterle RR, Raboni SM. Charlson comorbidity index scores and in-hospital prognosis of patients with severe acute respiratory infections. Intern Med J 2021; 50:691-697. [PMID: 31180163 DOI: 10.1111/imj.14398] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 06/03/2019] [Accepted: 06/03/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Respiratory infections are one of the leading causes of mortality, and comorbid conditions play a significant role in the severity and fatality of these infections. AIMS We evaluated the Charlson Comorbidity Index (CCI) score and possible predictors of mortality in hospitalised patients with severe acute respiratory infection (SARI), aiming to test if the CCI is a valid in-hospital prognostic indicator. METHODS Patients older than 14 years, hospitalised from 2010 to 2016 due to SARI by viral infection and who were submitted to respiratory virus testing were included. We assessed comorbidity retrospectively through chart review and calculated four variants of the CCI. RESULTS Of the 291 patients assessed, 72.8% (n = 212) presented comorbidities, and 24% died (n = 70). The most recurrent comorbidities were chronic pulmonary disease (n = 76/212, 36%) and HIV (n = 50/212, 23.6%). The 1994 age-adjusted CCI predicted in-hospital mortality in SARI patients (P = 0.04), and HIV was associated with in-hospital mortality (P = 0.032). CONCLUSIONS The comorbidity scores used to assess mortality risk in hospitalised patients with SARI displayed poor results, but HIV infection was considered a marker of severity. However, other factors should be considered in order to compose a score system that allows us to specifically assess the risk of mortality in patients with SARI.
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Affiliation(s)
- Nicholas W Setter
- Complexo Hospital de Clínicas, Infectious Diseases Unit, Universidade Federal do Paraná, Curitiba, Brazil
| | - Marcos L Peres
- Complexo Hospital de Clínicas, Infectious Diseases Unit, Universidade Federal do Paraná, Curitiba, Brazil
| | - Bernardo M M de Almeida
- Complexo Hospital de Clínicas, Epidemiology Unit, Universidade Federal do Paraná, Curitiba, Brazil
| | - Ricardo R Petterle
- Health Sciences Sector, Universidade Federal do Paraná, Curitiba, Brazil
| | - Sonia M Raboni
- Complexo Hospital de Clínicas, Infectious Diseases Unit, Universidade Federal do Paraná, Curitiba, Brazil
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12
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Chakrabarty RK, Beeler P, Liu P, Goswami S, Harvey RD, Pervez S, van Donkelaar A, Martin RV. Ambient PM 2.5 exposure and rapid spread of COVID-19 in the United States. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 760:143391. [PMID: 33250247 PMCID: PMC7651233 DOI: 10.1016/j.scitotenv.2020.143391] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 05/12/2023]
Abstract
It has been posited that populations being exposed to long-term air pollution are more susceptible to COVID-19. Evidence is emerging that long-term exposure to ambient PM2.5 (particulate matter with aerodynamic diameter 2.5 μm or less) associates with higher COVID-19 mortality rates, but whether it also associates with the speed at which the disease is capable of spreading in a population is unknown. Here, we establish the association between long-term exposure to ambient PM2.5 in the United States (US) and COVID-19 basic reproduction ratio R0- a dimensionless epidemic measure of the rapidity of disease spread through a population. We inferred state-level R0 values using a state-of-the-art susceptible, exposed, infected, and recovered (SEIR) model initialized with COVID-19 epidemiological data corresponding to the period March 2-April 30. This period was characterized by a rapid surge in COVID-19 cases across the US states, implementation of strict social distancing measures, and a significant drop in outdoor air pollution. We find that an increase of 1 μg/m3 in PM2.5 levels below current national ambient air quality standards associates with an increase of 0.25 in R0 (95% CI: 0.048-0.447). A 10% increase in secondary inorganic composition, sulfate-nitrate-ammonium, in PM2.5 associates with ≈10% increase in R0 by 0.22 (95% CI: 0.083-0.352), and presence of black carbon (soot) in the ambient environment moderates this relationship. We considered several potential confounding factors in our analysis, including gaseous air pollutants and socio-economical and meteorological conditions. Our results underscore two policy implications - first, regulatory standards need to be better guided by exploring the concentration-response relationships near the lower end of the PM2.5 air quality distribution; and second, pollution regulations need to be continually enforced for combustion emissions that largely determine secondary inorganic aerosol formation.
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Affiliation(s)
- Rajan K Chakrabarty
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO 63130, USA; Institute for Public Health, Washington University in St. Louis, St. Louis, MO 63130, USA.
| | - Payton Beeler
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Pai Liu
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Spondita Goswami
- Experimental Psychology Program, Department of Psychology, Saint Louis University, St. Louis, MO 63108, USA
| | - Richard D Harvey
- Experimental Psychology Program, Department of Psychology, Saint Louis University, St. Louis, MO 63108, USA
| | - Shamsh Pervez
- School of Studies in Chemistry, Pt. Ravishankar Shukla University, Raipur, Chhattisgarh 492010, India
| | - Aaron van Donkelaar
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO 63130, USA; Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Randall V Martin
- Center for Aerosol Science and Engineering, Department of Energy, Environmental and Chemical Engineering, Washington University in St. Louis, St. Louis, MO 63130, USA
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13
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Vahabi N, Salehi M, Duarte JD, Mollalo A, Michailidis G. County-level longitudinal clustering of COVID-19 mortality to incidence ratio in the United States. Sci Rep 2021; 11:3088. [PMID: 33542313 PMCID: PMC7862666 DOI: 10.1038/s41598-021-82384-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 01/18/2021] [Indexed: 01/30/2023] Open
Abstract
As of November 12, 2020, the mortality to incidence ratio (MIR) of COVID-19 was 5.8% in the US. A longitudinal model-based clustering system on the disease trajectories over time was used to identify "vulnerable" clusters of counties that would benefit from allocating additional resources by federal, state and county policymakers. County-level COVID-19 cases and deaths, together with a set of potential risk factors were collected for 3050 U.S. counties during the 1st wave of COVID-19 (Mar25-Jun3, 2020), followed by similar data for 1344 counties (in the "sunbelt" region of the country) during the 2nd wave (Jun4-Sep2, 2020), and finally for 1055 counties located broadly in the great plains region of the country during the 3rd wave (Sep3-Nov12, 2020). We used growth mixture models to identify clusters of counties exhibiting similar COVID-19 MIR growth trajectories and risk-factors over time. The analysis identifies "more vulnerable" clusters during the 1st, 2nd and 3rd waves of COVID-19. Further, tuberculosis (OR 1.3-2.1-3.2), drug use disorder (OR 1.1), hepatitis (OR 13.1), HIV/AIDS (OR 2.3), cardiomyopathy and myocarditis (OR 1.3), diabetes (OR 1.2), mesothelioma (OR 9.3) were significantly associated with increased odds of being in a more vulnerable cluster. Heart complications and cancer were the main risk factors increasing the COVID-19 MIR (range 0.08-0.52% MIR↑). We identified "more vulnerable" county-clusters exhibiting the highest COVID-19 MIR trajectories, indicating that enhancing the capacity and access to healthcare resources would be key to successfully manage COVID-19 in these clusters. These findings provide insights for public health policymakers on the groups of people and locations they need to pay particular attention while managing the COVID-19 epidemic.
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Affiliation(s)
- Nasim Vahabi
- Informatics Institute, University of Florida, Gainesville, FL, USA
| | - Masoud Salehi
- Department of Biostatistics, College of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Julio D Duarte
- Center for Pharmacogenomics, Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Abolfazl Mollalo
- Department of Public Health and Prevention Sciences, School of Health Sciences, Baldwin Wallace University, Berea, OH, USA
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14
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Siddique A, Shahzad A, Lawler J, Mahmoud KA, Lee DS, Ali N, Bilal M, Rasool K. Unprecedented environmental and energy impacts and challenges of COVID-19 pandemic. ENVIRONMENTAL RESEARCH 2021; 193:110443. [PMID: 33171120 PMCID: PMC7648503 DOI: 10.1016/j.envres.2020.110443] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/04/2020] [Accepted: 11/04/2020] [Indexed: 05/18/2023]
Abstract
The rapid transmission tendency, severity, and wide geographical spread of newly emerged novel coronavirus (SARS-CoV-2) in different environmental matrices, including water, air, and soil, has posed severe health, environmental, energy, and economic challenges worldwide. Despite the severe health effects, unprecedented improvements in air quality in many countries due to emergency measures, and public behavior changes have been reported. SARS-CoV-2 has been detected in air and sewage samples in several studies across the globe. The use of wastewater-based epidemiology (WBE) could be a valuable method to monitor the outbreak of COVID-19, which requires fast and reliable methods for virus detection in sewage. However, water treatment companies face many pressures due to potential for aerosolization, PPE shortages, and changed usage patterns. In addition, the unprecedented impact of the COVID-19 outbreak on the worldwide economy especially the energy sector, and its impact on our ecosystem required instant responses. This article discusses the recent developments and challenges faced in water, air, and energy resources, including renewables and non-renewables as the significant and interrelated components of the ecosystem. Furthermore, some recommendations have been directed, which may serve as a guideline to the scientists, legislators, and other stakeholders. A future roadmap has been proposed to overcome the tragic effects of COVID-19 and developing a sustainable environmental system to minimize the impact of such infectious outbreaks in the future.
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Affiliation(s)
- Azhar Siddique
- Qatar Environment and Energy Research Institute (QEERI), Hamad Bin Khalifa University, Qatar Foundation, P.O. Box 5825, Doha, Qatar
| | - Asif Shahzad
- Department of Energy and Materials Engineering, Dongguk University, Seoul, 04620, Republic of Korea
| | - Jenny Lawler
- Qatar Environment and Energy Research Institute (QEERI), Hamad Bin Khalifa University, Qatar Foundation, P.O. Box 5825, Doha, Qatar
| | - Khaled A Mahmoud
- Qatar Environment and Energy Research Institute (QEERI), Hamad Bin Khalifa University, Qatar Foundation, P.O. Box 5825, Doha, Qatar
| | - Dae Sung Lee
- Department of Environmental Engineering, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu, 41566, Republic of Korea
| | - Nisar Ali
- Key Laboratory for Palygorskite Science and Applied Technology of Jiangsu Province, National & Local Joint Engineering Research Centre for Deep Utilization Technology of Rock-salt Resource, Faculty of Chemical Engineering, Huaiyin Institute of Technology, Huai'an, 223003, China
| | - Muhammad Bilal
- School of Life Science and Food Engineering, Huaiyin Institute of Technology, Huai'an, 223003, China
| | - Kashif Rasool
- Qatar Environment and Energy Research Institute (QEERI), Hamad Bin Khalifa University, Qatar Foundation, P.O. Box 5825, Doha, Qatar.
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15
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Pan J, St. Pierre JM, Pickering TA, Demirjian NL, Fields BK, Desai B, Gholamrezanezhad A. Coronavirus Disease 2019 (COVID-19): A Modeling Study of Factors Driving Variation in Case Fatality Rate by Country. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218189. [PMID: 33167564 PMCID: PMC7664233 DOI: 10.3390/ijerph17218189] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/26/2020] [Accepted: 11/02/2020] [Indexed: 12/20/2022]
Abstract
Background: The novel Severe Acute Respiratory Syndrome Coronavirus-2 has led to a global pandemic in which case fatality rate (CFR) has varied from country to country. This study aims to identify factors that may explain the variation in CFR across countries. Methods: We identified 24 potential risk factors affecting CFR. For all countries with over 5000 reported COVID-19 cases, we used country-specific datasets from the WHO, the OECD, and the United Nations to quantify each of these factors. We examined univariable relationships of each variable with CFR, as well as correlations among predictors and potential interaction terms. Our final multivariable negative binomial model included univariable predictors of significance and all significant interaction terms. Results: Across the 39 countries under consideration, our model shows COVID-19 case fatality rate was best predicted by time to implementation of social distancing measures, hospital beds per 1000 individuals, percent population over 70 years, CT scanners per 1 million individuals, and (in countries with high population density) smoking prevalence. Conclusion: Our model predicted an increased CFR for countries that waited over 14 days to implement social distancing interventions after the 100th reported case. Smoking prevalence and percentage population over the age of 70 years were also associated with higher CFR. Hospital beds per 1000 and CT scanners per million were identified as possible protective factors associated with decreased CFR.
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Affiliation(s)
- Jennifer Pan
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (J.P.); (J.M.S.P.); (T.A.P.); (N.L.D.); (B.K.K.F.); (B.D.)
| | - Joseph Marie St. Pierre
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (J.P.); (J.M.S.P.); (T.A.P.); (N.L.D.); (B.K.K.F.); (B.D.)
| | - Trevor A. Pickering
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (J.P.); (J.M.S.P.); (T.A.P.); (N.L.D.); (B.K.K.F.); (B.D.)
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Natalie L. Demirjian
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (J.P.); (J.M.S.P.); (T.A.P.); (N.L.D.); (B.K.K.F.); (B.D.)
- Department of Integrative Anatomical Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Brandon K.K. Fields
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (J.P.); (J.M.S.P.); (T.A.P.); (N.L.D.); (B.K.K.F.); (B.D.)
| | - Bhushan Desai
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (J.P.); (J.M.S.P.); (T.A.P.); (N.L.D.); (B.K.K.F.); (B.D.)
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Ali Gholamrezanezhad
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; (J.P.); (J.M.S.P.); (T.A.P.); (N.L.D.); (B.K.K.F.); (B.D.)
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- Correspondence: ; Tel.: +443-839-7134
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16
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Mishra R, Krishnamoorthy P, Gangamma S, Raut AA, Kumar H. Particulate matter (PM 10) enhances RNA virus infection through modulation of innate immune responses. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 266:115148. [PMID: 32771845 PMCID: PMC7357538 DOI: 10.1016/j.envpol.2020.115148] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/28/2020] [Accepted: 06/28/2020] [Indexed: 05/07/2023]
Abstract
Sensing of pathogens by specialized receptors is the hallmark of the innate immunity. Innate immune response also mounts a defense response against various allergens and pollutants including particulate matter present in the atmosphere. Air pollution has been included as the top threat to global health declared by WHO which aims to cover more than three billion people against health emergencies from 2019 to 2023. Particulate matter (PM), one of the major components of air pollution, is a significant risk factor for many human diseases and its adverse effects include morbidity and premature deaths throughout the world. Several clinical and epidemiological studies have identified a key link between the PM existence and the prevalence of respiratory and inflammatory disorders. However, the underlying molecular mechanism is not well understood. Here, we investigated the influence of air pollutant, PM10 (particles with aerodynamic diameter less than 10 μm) during RNA virus infections using Highly Pathogenic Avian Influenza (HPAI) - H5N1 virus. We thus characterized the transcriptomic profile of lung epithelial cell line, A549 treated with PM10 prior to H5N1infection, which is known to cause severe lung damage and respiratory disease. We found that PM10 enhances vulnerability (by cellular damage) and regulates virus infectivity to enhance overall pathogenic burden in the lung cells. Additionally, the transcriptomic profile highlights the connection of host factors related to various metabolic pathways and immune responses which were dysregulated during virus infection. Collectively, our findings suggest a strong link between the prevalence of respiratory illness and its association with the air quality.
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Affiliation(s)
- Richa Mishra
- Laboratory of Immunology and Infectious Disease Biology, Department of Biological Sciences, Indian Institute of Science Education and Research (IISER) Bhopal, Bhopal, 462066, MP, India
| | - Pandikannan Krishnamoorthy
- Laboratory of Immunology and Infectious Disease Biology, Department of Biological Sciences, Indian Institute of Science Education and Research (IISER) Bhopal, Bhopal, 462066, MP, India
| | - S Gangamma
- National Institute of Technology Karnataka (NITK), Surathkal, Mangaluru, 575025, Karnataka, India; Centre for Water Food and Environment, IIT Ropar, Rupnagar, 140001, Punjab, India
| | - Ashwin Ashok Raut
- Pathogenomics Laboratory, ICAR - National Institute of High Security Animal Diseases (NIHSAD), OIE Reference Laboratory for Avian Influenza, Bhopal, 462021, MP, India
| | - Himanshu Kumar
- Laboratory of Immunology and Infectious Disease Biology, Department of Biological Sciences, Indian Institute of Science Education and Research (IISER) Bhopal, Bhopal, 462066, MP, India; WPI Immunology, Frontier Research Centre, Osaka University, Osaka, 5650871, Japan.
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17
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Wu X, Nethery RC, Sabath MB, Braun D, Dominici F. Air pollution and COVID-19 mortality in the United States: Strengths and limitations of an ecological regression analysis. SCIENCE ADVANCES 2020; 6:6/45/eabd4049. [PMID: 33148655 DOI: 10.1101/2020.04.05.20054502v2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/18/2020] [Indexed: 05/23/2023]
Abstract
Assessing whether long-term exposure to air pollution increases the severity of COVID-19 health outcomes, including death, is an important public health objective. Limitations in COVID-19 data availability and quality remain obstacles to conducting conclusive studies on this topic. At present, publicly available COVID-19 outcome data for representative populations are available only as area-level counts. Therefore, studies of long-term exposure to air pollution and COVID-19 outcomes using these data must use an ecological regression analysis, which precludes controlling for individual-level COVID-19 risk factors. We describe these challenges in the context of one of the first preliminary investigations of this question in the United States, where we found that higher historical PM2.5 exposures are positively associated with higher county-level COVID-19 mortality rates after accounting for many area-level confounders. Motivated by this study, we lay the groundwork for future research on this important topic, describe the challenges, and outline promising directions and opportunities.
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Affiliation(s)
- X Wu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - R C Nethery
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - M B Sabath
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - D Braun
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - F Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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18
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Wu X, Nethery RC, Sabath MB, Braun D, Dominici F. Air pollution and COVID-19 mortality in the United States: Strengths and limitations of an ecological regression analysis. SCIENCE ADVANCES 2020; 6:6/45/eabd4049. [PMID: 33148655 DOI: 10.1126/sciadv.abd404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/18/2020] [Indexed: 05/26/2023]
Abstract
Assessing whether long-term exposure to air pollution increases the severity of COVID-19 health outcomes, including death, is an important public health objective. Limitations in COVID-19 data availability and quality remain obstacles to conducting conclusive studies on this topic. At present, publicly available COVID-19 outcome data for representative populations are available only as area-level counts. Therefore, studies of long-term exposure to air pollution and COVID-19 outcomes using these data must use an ecological regression analysis, which precludes controlling for individual-level COVID-19 risk factors. We describe these challenges in the context of one of the first preliminary investigations of this question in the United States, where we found that higher historical PM2.5 exposures are positively associated with higher county-level COVID-19 mortality rates after accounting for many area-level confounders. Motivated by this study, we lay the groundwork for future research on this important topic, describe the challenges, and outline promising directions and opportunities.
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Affiliation(s)
- X Wu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - R C Nethery
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - M B Sabath
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - D Braun
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - F Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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19
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Wu X, Nethery RC, Sabath MB, Braun D, Dominici F. Air pollution and COVID-19 mortality in the United States: Strengths and limitations of an ecological regression analysis. SCIENCE ADVANCES 2020; 6:6/45/eabd4049. [PMID: 33148655 DOI: 10.1101/2020.04.05.20054502v1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/18/2020] [Indexed: 05/22/2023]
Abstract
Assessing whether long-term exposure to air pollution increases the severity of COVID-19 health outcomes, including death, is an important public health objective. Limitations in COVID-19 data availability and quality remain obstacles to conducting conclusive studies on this topic. At present, publicly available COVID-19 outcome data for representative populations are available only as area-level counts. Therefore, studies of long-term exposure to air pollution and COVID-19 outcomes using these data must use an ecological regression analysis, which precludes controlling for individual-level COVID-19 risk factors. We describe these challenges in the context of one of the first preliminary investigations of this question in the United States, where we found that higher historical PM2.5 exposures are positively associated with higher county-level COVID-19 mortality rates after accounting for many area-level confounders. Motivated by this study, we lay the groundwork for future research on this important topic, describe the challenges, and outline promising directions and opportunities.
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Affiliation(s)
- X Wu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - R C Nethery
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - M B Sabath
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - D Braun
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - F Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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20
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Wu X, Nethery RC, Sabath MB, Braun D, Dominici F. Air pollution and COVID-19 mortality in the United States: Strengths and limitations of an ecological regression analysis. SCIENCE ADVANCES 2020; 6:eabd4049. [PMID: 33148655 PMCID: PMC7673673 DOI: 10.1126/sciadv.abd4049] [Citation(s) in RCA: 525] [Impact Index Per Article: 131.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/18/2020] [Indexed: 05/17/2023]
Abstract
Assessing whether long-term exposure to air pollution increases the severity of COVID-19 health outcomes, including death, is an important public health objective. Limitations in COVID-19 data availability and quality remain obstacles to conducting conclusive studies on this topic. At present, publicly available COVID-19 outcome data for representative populations are available only as area-level counts. Therefore, studies of long-term exposure to air pollution and COVID-19 outcomes using these data must use an ecological regression analysis, which precludes controlling for individual-level COVID-19 risk factors. We describe these challenges in the context of one of the first preliminary investigations of this question in the United States, where we found that higher historical PM2.5 exposures are positively associated with higher county-level COVID-19 mortality rates after accounting for many area-level confounders. Motivated by this study, we lay the groundwork for future research on this important topic, describe the challenges, and outline promising directions and opportunities.
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Affiliation(s)
- X Wu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - R C Nethery
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - M B Sabath
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - D Braun
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA
| | - F Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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More AF, Loveluck CP, Clifford H, Handley MJ, Korotkikh EV, Kurbatov AV, McCormick M, Mayewski PA. The Impact of a Six-Year Climate Anomaly on the "Spanish Flu" Pandemic and WWI. GEOHEALTH 2020; 4:e2020GH000277. [PMID: 33005839 PMCID: PMC7513628 DOI: 10.1029/2020gh000277] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/24/2020] [Accepted: 08/27/2020] [Indexed: 05/25/2023]
Abstract
The H1N1 "Spanish influenza" pandemic of 1918-1919 caused the highest known number of deaths recorded for a single pandemic in human history. Several theories have been offered to explain the virulence and spread of the disease, but the environmental context remains underexamined. In this study, we present a new environmental record from a European, Alpine ice core, showing a significant climate anomaly that affected the continent from 1914 to 1919. Incessant torrential rain and declining temperatures increased casualties in the battlefields of World War I (WWI), setting the stage for the spread of the pandemic at the end of the conflict. Multiple independent records of temperature, precipitation, and mortality corroborate these findings.
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Affiliation(s)
- Alexander F. More
- Initiative for the Science of the Human PastHarvard UniversityCambridgeMAUSA
- Climate Change InstituteUniversity of MaineOronoMEUSA
- Department of Public HealthLong Island UniversityNew York CityNYUSA
| | - Christopher P. Loveluck
- Department of Classics and Archeology, School of HumanitiesUniversity of NottinghamNottinghamUK
| | | | | | | | | | - Michael McCormick
- Initiative for the Science of the Human PastHarvard UniversityCambridgeMAUSA
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22
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Mathiesen T, Arraez M, Asser T, Balak N, Barazi S, Bernucci C, Bolger C, Broekman MLD, Demetriades AK, Feldman Z, Fontanella MM, Foroglou N, Lafuente J, Maier AD, Meyer B, Niemelä M, Roche PH, Sala F, Samprón N, Sandvik U, Schaller K, Thome C, Thys M, Tisell M, Vajkoczy P, Visocchi M. A snapshot of European neurosurgery December 2019 vs. March 2020: just before and during the Covid-19 pandemic. Acta Neurochir (Wien) 2020; 162:2221-2233. [PMID: 32642834 PMCID: PMC7343382 DOI: 10.1007/s00701-020-04482-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/30/2020] [Indexed: 11/30/2022]
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or Covid-19), which began as an epidemic in China and spread globally as a pandemic, has necessitated resource management to meet emergency needs of Covid-19 patients and other emergent cases. We have conducted a survey to analyze caseload and measures to adapt indications for a perception of crisis. Methods We constructed a questionnaire to survey a snapshot of neurosurgical activity, resources, and indications during 1 week with usual activity in December 2019 and 1 week during SARS-CoV-2 pandemic in March 2020. The questionnaire was sent to 34 neurosurgical departments in Europe; 25 departments returned responses within 5 days. Results We found unexpectedly large differences in resources and indications already before the pandemic. Differences were also large in how much practice and resources changed during the pandemic. Neurosurgical beds and neuro-intensive care beds were significantly decreased from December 2019 to March 2020. The utilization of resources decreased via less demand for care of brain injuries and subarachnoid hemorrhage, postponing surgery and changed surgical indications as a method of rationing resources. Twenty departments (80%) reduced activity extensively, and the same proportion stated that they were no longer able to provide care according to legitimate medical needs. Conclusion Neurosurgical centers responded swiftly and effectively to a sudden decrease of neurosurgical capacity due to relocation of resources to pandemic care. The pandemic led to rationing of neurosurgical care in 80% of responding centers. We saw a relation between resources before the pandemic and ability to uphold neurosurgical services. The observation of extensive differences of available beds provided an opportunity to show how resources that had been restricted already under normal conditions translated to rationing of care that may not be acceptable to the public of seemingly affluent European countries. Electronic supplementary material The online version of this article (10.1007/s00701-020-04482-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- T Mathiesen
- Department of Neurosurgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - M Arraez
- Department of Neurosurgery, Carlos Haya University Hospital,, University of Malaga, Malaga, Spain
| | - T Asser
- University of Tartu, Tartu, Estonia
| | - N Balak
- Department of Neurosurgery, Istanbul Medeniyet University, Göztepe Education and Research Hospital, Istanbul, Turkey
| | - S Barazi
- King's College Hospital, London, UK
| | - C Bernucci
- Department of Neuroscience and Surgery of the Nervous System, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - C Bolger
- National Centre for Neurosurgery, Beaumont Hospital, Dublin, Ireland
| | - M L D Broekman
- Departments of Neurosurgery, Haaglanden Medical Center and Leiden University Medical Center, Leiden University, Leiden, Zuid-Holland, the Netherlands
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - A K Demetriades
- Department of Neurosurgery, Western General Hospital, Edinburgh, UK
| | - Z Feldman
- Department of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | - M M Fontanella
- Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia, Brescia, Italy
| | - N Foroglou
- Department of Neurosurgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - J Lafuente
- Neurosurgery, Hospital Del Mar, Barcelona, Spain
| | - A D Maier
- Department of Neurosurgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - B Meyer
- Department of Neurosurgery, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany
| | - M Niemelä
- Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - P H Roche
- Department of Neurosurgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Aix Marseille Université, Marseille, France
| | - F Sala
- Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, Verona, Italy
| | - N Samprón
- Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Spain
| | - U Sandvik
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Neurosurgery, Karolinska University Hospital, Solna, Sweden
| | - K Schaller
- Department of Neurosurgery, Geneva University Medical Center & Faculty of Medicine, Geneva, Switzerland
| | - C Thome
- Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria
| | - M Thys
- Neurosciences Department, Grand Hopital de Charleroi, Charleroi, Belgium
| | - M Tisell
- Department of Neurosurgery, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - P Vajkoczy
- Department of Neurosurgery, Charite Universitätsmedizin Berlin, Berlin, Germany
| | - M Visocchi
- Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
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Domingo JL, Rovira J. Effects of air pollutants on the transmission and severity of respiratory viral infections. ENVIRONMENTAL RESEARCH 2020; 187:109650. [PMID: 32416357 PMCID: PMC7211639 DOI: 10.1016/j.envres.2020.109650] [Citation(s) in RCA: 178] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 05/13/2023]
Abstract
Particulate matter, sulfur dioxide, nitrogen oxides, ozone, carbon monoxide, volatile organic compounds (VOCs) and polycyclic aromatic hydrocarbons (PAHs) are among the outdoor air pollutants that are major factors in diseases, causing especially adverse respiratory effects in humans. On the other hand, the role of respiratory viruses in the pathogenesis of severe respiratory infections is an issue of great importance. The present literature review was aimed at assessing the potential effects of air pollutants on the transmission and severity of respiratory viral infections. We have reviewed the scientific literature regarding the association of outdoor air pollution and respiratory viruses on respiratory diseases. Evidence supports a clear association between air concentrations of some pollutants and human respiratory viruses interacting to adversely affect the respiratory system. Given the undoubted importance and topicality of the subject, we have paid special attention to the association between air pollutants and the transmission and severity of the effects caused by the coronavirus named SARS-CoV-2, which causes the COVID-19. Although to date, and by obvious reasons, the number of studies on this issue are still scarce, most results indicate that chronic exposure to air pollutants delays/complicates recovery of patients of COVID-19 and leads to more severe and lethal forms of this disease. This deserves immediate and in-depth experimental investigations.
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Affiliation(s)
- José L Domingo
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorens 21, 43201, Reus, Catalonia, Spain.
| | - Joaquim Rovira
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorens 21, 43201, Reus, Catalonia, Spain; Departament d'Enginyeria Química, Universitat Rovira i Virgili, Avd. Països Catalans 26, 43007, Tarragona, Catalonia, Spain
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Hussain M, Nasir N, Irfan M, Hasan Z. Clinical characteristics and outcomes of patients with H1N1 influenza pneumonia admitted at a tertiary care hospital in Karachi, Pakistan. Pneumonia (Nathan) 2020; 12:5. [PMID: 32637295 PMCID: PMC7335362 DOI: 10.1186/s41479-020-00070-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/08/2020] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Influenza viruses specifically, A and B mainly contribute to seasonal outbreaks that occur globally. However, due to limited diagnostics for influenza there is little data regarding clinical outcomes of patients with H1N1 pneumonia in our region. Our objective was to determine the clinical characteristics and outcomes of patients hospitalized with H1N1 pneumonia at a tertiary care facility in Karachi, Pakistan. METHODS A retrospective study of adult patients admitted with influenza pneumonia from November 2017 to February 2018 at a tertiary care hospital in Karachi, Pakistan. Patient characteristics were compared between influenza A H1N1 and other types of influenza using multivariable logistic regression analysis and subgroup analysis for factors associated with mortality in H1N1 Pneumonia was performed. RESULTS Out of 497 adult patients with community acquired pneumonia (CAP), 172 fulfilled the criteria for Influenza like illness (ILI). 88 patients had PCR confirmed Influenza pneumonia of whom n = 57 (65%) had Influenza A H1N1. The mean age of patients 53.5 years (SD: 17.3) and 60% were male. The overall mortality from Influenza in this study was 15.9% (n = 14); out of these 11 (78.5%) had Influenza A H1N1. Multivariable analysis showed that the increase in length of hospital admission was significantly associated with H1N1 Influenza A infection (OR: 1.47 CI: 1.2-1.8). Factors associated with mortality showed that presence of ARDS, Septic shock and multi-organ failure was highly significantly associated with death (p-value < 0.001) along with deranged liver function tests (p-value 0.01) and presence of nosocomial infection (p-value 0.027). CONCLUSION Influenza A H1N1 is associated with greater length of stay compared with infection due to other types of Influenza and mortality in H1N1 Pneumonia was found to be associated with presence of nosocomial infection among several other factors which may have implications given higher rates in a low-middle income country.
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Affiliation(s)
- Mujahid Hussain
- Department of Medicine, Section of Pulmonary and Critical Care Medicine, Aga Khan University, Karachi, Pakistan
| | - Nosheen Nasir
- Department of Medicine, Section of Infectious Diseases, Aga Khan University, Karachi, Pakistan
| | - Muhammad Irfan
- Department of Medicine, Section of Pulmonary and Critical Care Medicine, Aga Khan University, Karachi, Pakistan
| | - Zahra Hasan
- Department of Pathology and Laboratory Medicine, Section of Molecular Pathology, Aga Khan University, Karachi, Pakistan
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Bulled N, Singer M. In the shadow of HIV & TB: A commentary on the COVID epidemic in South Africa. Glob Public Health 2020; 15:1231-1243. [PMID: 32486906 DOI: 10.1080/17441692.2020.1775275] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
While COVID-19 has become a global pandemic that has spread to all regions of the globe, local historic, health, and socio-environmental factors shape the epidemiological contours, response, and social challenges present within each affected nation. Thus, while countries like China, Italy, Iran, Brazil, and the United States have all been hard hit by the pandemic, there are critical differences across these nations in a number of variables (e.g. demographic features, health histories, healthcare systems, infection case rates, case fatality rates, national responses). In other words, within the global pandemic there are multiple importantly distinct national epidemics. Overcoming the grave threats to public health presented by COVID-19 requires both international cooperation and country-specific efforts that reflect local histories, needs, and resources. Already concerns are being expressed among health officials about how COVID-19 might be devastating in Africa. Currently, South Africa has the highest number of diagnosed COVID-19 cases on the continent and has been identified as being at high risk in the pandemic. This paper examines the public health response to the COVID-19 threat, how the prior and ongoing HIV and TB epidemics shape the COVID-19 epidemic and influence the response, and the potential ramifications of the response.
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Affiliation(s)
- Nicola Bulled
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Merrill Singer
- Department of Anthropology, University of Connecticut, Storrs, CT, USA
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Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [...]
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Exposure to air pollution and COVID-19 mortality in the United States: A nationwide cross-sectional study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020. [PMID: 32511651 DOI: 10.1101/2020.04.05.20054502] [Citation(s) in RCA: 389] [Impact Index Per Article: 97.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES United States government scientists estimate that COVID-19 may kill tens of thousands of Americans. Many of the pre-existing conditions that increase the risk of death in those with COVID-19 are the same diseases that are affected by long-term exposure to air pollution. We investigated whether long-term average exposure to fine particulate matter (PM 2.5 ) is associated with an increased risk of COVID-19 death in the United States. DESIGN A nationwide, cross-sectional study using county-level data. DATA SOURCES COVID-19 death counts were collected for more than 3,000 counties in the United States (representing 98% of the population) up to April 22, 2020 from Johns Hopkins University, Center for Systems Science and Engineering Coronavirus Resource Center. MAIN OUTCOME MEASURES We fit negative binomial mixed models using county-level COVID-19 deaths as the outcome and county-level long-term average of PM 2.5 as the exposure. In the main analysis, we adjusted by 20 potential confounding factors including population size, age distribution, population density, time since the beginning of the outbreak, time since state issuance of the stay-at-home order, hospital beds, number of individuals tested, weather, and socioeconomic and behavioral variables such as obesity and smoking. We included a random intercept by state to account for potential correlation in counties within the same state. We conducted more than 68 additional sensitivity analyses. RESULTS We found that an increase of only 1 μg/m 3 in PM 2.5 is associated with an 8% increase in the COVID-19 death rate (95% confidence interval [CI]: 2%, 15%). The results were statistically significant and robust to secondary and sensitivity analyses. CONCLUSIONS A small increase in long-term exposure to PM 2.5 leads to a large increase in the COVID-19 death rate. Despite the inherent limitations of the ecological study design, our results underscore the importance of continuing to enforce existing air pollution regulations to protect human health both during and after the COVID-19 crisis. The data and code are publicly available so our analyses can be updated routinely.
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Paget J, Spreeuwenberg P, Charu V, Taylor RJ, Iuliano AD, Bresee J, Simonsen L, Viboud C. Global mortality associated with seasonal influenza epidemics: New burden estimates and predictors from the GLaMOR Project. J Glob Health 2020; 9:020421. [PMID: 31673337 PMCID: PMC6815659 DOI: 10.7189/jogh.09.020421] [Citation(s) in RCA: 330] [Impact Index Per Article: 82.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Until recently, the World Health Organization (WHO) estimated the annual mortality burden of influenza to be 250 000 to 500 000 all-cause deaths globally; however, a 2017 study indicated a substantially higher mortality burden, at 290 000-650 000 influenza-associated deaths from respiratory causes alone, and a 2019 study estimated 99 000-200 000 deaths from lower respiratory tract infections directly caused by influenza. Here we revisit global and regional estimates of influenza mortality burden and explore mortality trends over time and geography. Methods We compiled influenza-associated excess respiratory mortality estimates for 31 countries representing 5 WHO regions during 2002-2011. From these we extrapolated the influenza burden for all 193 countries of the world using a multiple imputation approach. We then used mixed linear regression models to identify factors associated with high seasonal influenza mortality burden, including influenza types and subtypes, health care and socio-demographic development indicators, and baseline mortality levels. Results We estimated an average of 389 000 (uncertainty range 294 000-518 000) respiratory deaths were associated with influenza globally each year during the study period, corresponding to ~ 2% of all annual respiratory deaths. Of these, 67% were among people 65 years and older. Global burden estimates were robust to the choice of countries included in the extrapolation model. For people <65 years, higher baseline respiratory mortality, lower level of access to health care and seasons dominated by the A(H1N1)pdm09 subtype were associated with higher influenza-associated mortality, while lower level of socio-demographic development and A(H3N2) dominance was associated with higher influenza mortality in adults ≥65 years. Conclusions Our global estimate of influenza-associated excess respiratory mortality is consistent with the 2017 estimate, despite a different modelling strategy, and the lower 2019 estimate which only captured deaths directly caused by influenza. Our finding that baseline respiratory mortality and access to health care are associated with influenza-related mortality in persons <65 years suggests that health care improvements in low and middle-income countries might substantially reduce seasonal influenza mortality. Our estimates add to the body of evidence on the variation in influenza burden over time and geography, and begin to address the relationship between influenza-associated mortality, health and development.
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Affiliation(s)
- John Paget
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | - Peter Spreeuwenberg
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | - Vivek Charu
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA.,Stanford University, Stanford, California, USA
| | | | | | - Joseph Bresee
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lone Simonsen
- George Washington University, Washington, D.C., USA.,Roskilde University, Roskilde, Denmark
| | - Cecile Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
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Al-kuraishy H, Al-Maiahy T, Al-Gareeb A, Musa R, Ali Z. COVID-19 pneumonia in an Iraqi pregnant woman with preterm delivery. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2020. [DOI: 10.4103/2305-0500.282984] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Tuberculosis as a Risk Factor for 1918 Influenza Pandemic Outcomes. Trop Med Infect Dis 2019; 4:tropicalmed4020074. [PMID: 31035651 PMCID: PMC6630781 DOI: 10.3390/tropicalmed4020074] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 04/14/2019] [Accepted: 04/26/2019] [Indexed: 01/30/2023] Open
Abstract
Tuberculosis (TB) mortality declined after the 1918 pandemic, suggesting that influenza killed those who would have died from TB. Few studies have analyzed TB as a direct risk factor for 1918 influenza morbidity and mortality by age and sex. We study the impacts of TB on influenza-like illness (% of population sick) and case fatality (% of cases dying) by age and sex through case-control comparisons of patients (N = 201) and employees (N = 97) from two Norwegian sanatoriums. Female patients, patients at Landeskogen sanatorium, and patients aged 10–39 years had significantly lower morbidity than the controls. None of the 62 sick employees died, while 15 of 84 sick patients did. The case-control difference in case fatality by sex was only significant for females at Lyster sanatorium and females at both sanatoriums combined. Non-significant case-control differences in case fatality for males were likely due to small samples. Patients 20–29 years for both sexes combined at Lyster sanatorium and at both sanatoriums combined, as well as females 20–29 years for both sanatoriums combined, had significantly higher case fatality. We conclude that TB was associated with higher case fatality, but morbidity was lower for patients than for employees. The results add to the study of interactions between bacterial and viral diseases and are relevant in preparing for pandemics in TB endemic areas.
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Blanco-Lobo P, Nogales A, Rodríguez L, Martínez-Sobrido L. Novel Approaches for The Development of Live Attenuated Influenza Vaccines. Viruses 2019; 11:E190. [PMID: 30813325 PMCID: PMC6409754 DOI: 10.3390/v11020190] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 02/19/2019] [Accepted: 02/19/2019] [Indexed: 01/04/2023] Open
Abstract
Influenza virus still represents a considerable threat to global public health, despite the advances in the development and wide use of influenza vaccines. Vaccination with traditional inactivate influenza vaccines (IIV) or live-attenuated influenza vaccines (LAIV) remains the main strategy in the control of annual seasonal epidemics, but it does not offer protection against new influenza viruses with pandemic potential, those that have shifted. Moreover, the continual antigenic drift of seasonal circulating influenza viruses, causing an antigenic mismatch that requires yearly reformulation of seasonal influenza vaccines, seriously compromises vaccine efficacy. Therefore, the quick optimization of vaccine production for seasonal influenza and the development of new vaccine approaches for pandemic viruses is still a challenge for the prevention of influenza infections. Moreover, recent reports have questioned the effectiveness of the current LAIV because of limited protection, mainly against the influenza A virus (IAV) component of the vaccine. Although the reasons for the poor protection efficacy of the LAIV have not yet been elucidated, researchers are encouraged to develop new vaccination approaches that overcome the limitations that are associated with the current LAIV. The discovery and implementation of plasmid-based reverse genetics has been a key advance in the rapid generation of recombinant attenuated influenza viruses that can be used for the development of new and most effective LAIV. In this review, we provide an update regarding the progress that has been made during the last five years in the development of new LAIV and the innovative ways that are being explored as alternatives to the currently licensed LAIV. The safety, immunogenicity, and protection efficacy profile of these new LAIVs reveal their possible implementation in combating influenza infections. However, efforts by vaccine companies and government agencies will be needed for controlled testing and approving, respectively, these new vaccine methodologies for the control of influenza infections.
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Affiliation(s)
- Pilar Blanco-Lobo
- Department of Microbiology and Immunology, School of Medicine and Dentistry, University of Rochester, Rochester, New York, NY 14642, USA.
| | - Aitor Nogales
- Department of Microbiology and Immunology, School of Medicine and Dentistry, University of Rochester, Rochester, New York, NY 14642, USA.
| | - Laura Rodríguez
- Department of Microbiology and Immunology, School of Medicine and Dentistry, University of Rochester, Rochester, New York, NY 14642, USA.
| | - Luis Martínez-Sobrido
- Department of Microbiology and Immunology, School of Medicine and Dentistry, University of Rochester, Rochester, New York, NY 14642, USA.
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Spreeuwenberg P, Kroneman M, Paget J. Reassessing the Global Mortality Burden of the 1918 Influenza Pandemic. Am J Epidemiol 2018; 187:2561-2567. [PMID: 30202996 PMCID: PMC7314216 DOI: 10.1093/aje/kwy191] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 08/17/2018] [Accepted: 08/20/2018] [Indexed: 11/13/2022] Open
Abstract
Mortality estimates of the 1918 influenza pandemic vary considerably, and recent estimates have suggested that there were 50 million to 100 million deaths worldwide. We investigated the global mortality burden using an indirect estimation approach and 2 publicly available data sets: the Human Mortality Database (13 countries) and data extracted from the records of the Statistical Abstract for British India. The all-cause Human Mortality Database was used to estimate mortality annually for 1916-1921 for detailed age groups. Three different calculation methods were applied to the data (low, medium, and high scenarios), and we used a multilevel regression model to control for distorting factors (e.g., war and the underlying time trend in mortality). Total pandemic mortality was an estimated 15 million deaths worldwide in 1918 (n = 2.5 million in 1919) after including the rates for British India and controlling for wars and the underlying mortality trend. According to our validity analysis, simulations of total number of deaths being greater than 25 million are not realistic based on the underlying mortality rates included in Human Mortality Database and in British India. Our results suggest the global death impact of the 1918 pandemic was important (n = 17.4 million) but not as severe as most frequently cited estimates.
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Short KR, Kedzierska K, van de Sandt CE. Back to the Future: Lessons Learned From the 1918 Influenza Pandemic. Front Cell Infect Microbiol 2018; 8:343. [PMID: 30349811 PMCID: PMC6187080 DOI: 10.3389/fcimb.2018.00343] [Citation(s) in RCA: 145] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 09/10/2018] [Indexed: 01/02/2023] Open
Abstract
2018 marks the 100-year anniversary of the 1918 influenza pandemic, which killed ~50 million people worldwide. The severity of this pandemic resulted from a complex interplay between viral, host, and societal factors. Here, we review the viral, genetic and immune factors that contributed to the severity of the 1918 pandemic and discuss the implications for modern pandemic preparedness. We address unresolved questions of why the 1918 influenza H1N1 virus was more virulent than other influenza pandemics and why some people survived the 1918 pandemic and others succumbed to the infection. While current studies suggest that viral factors such as haemagglutinin and polymerase gene segments most likely contributed to a potent, dysregulated pro-inflammatory cytokine storm in victims of the pandemic, a shift in case-fatality for the 1918 pandemic toward young adults was most likely associated with the host's immune status. Lack of pre-existing virus-specific and/or cross-reactive antibodies and cellular immunity in children and young adults likely contributed to the high attack rate and rapid spread of the 1918 H1N1 virus. In contrast, lower mortality rate in in the older (>30 years) adult population points toward the beneficial effects of pre-existing cross-reactive immunity. In addition to the role of humoral and cellular immunity, there is a growing body of evidence to suggest that individual genetic differences, especially involving single-nucleotide polymorphisms (SNPs), contribute to differences in the severity of influenza virus infections. Co-infections with bacterial pathogens, and possibly measles and malaria, co-morbidities, malnutrition or obesity are also known to affect the severity of influenza disease, and likely influenced 1918 H1N1 disease severity and outcomes. Additionally, we also discuss the new challenges, such as changing population demographics, antibiotic resistance and climate change, which we will face in the context of any future influenza virus pandemic. In the last decade there has been a dramatic increase in the number of severe influenza virus strains entering the human population from animal reservoirs (including highly pathogenic H7N9 and H5N1 viruses). An understanding of past influenza virus pandemics and the lessons that we have learnt from them has therefore never been more pertinent.
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Affiliation(s)
- Kirsty R. Short
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Katherine Kedzierska
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC, Australia
| | - Carolien E. van de Sandt
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC, Australia
- Department of Hematopoiesis, Sanquin Research and Landsteiner Laboratory, Amsterdam, Netherlands
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