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Bin X, Qu KY, Wang YH, Chen L, Xiong YJ, Wen JF, Wei HB, Bing T, Dan CY, Zhu JQ. Prevalence of depression, anxiety in China during the COVID-19 pandemic: an updated systematic review and meta-analysis. Front Public Health 2024; 11:1267764. [PMID: 38249392 PMCID: PMC10796455 DOI: 10.3389/fpubh.2023.1267764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 12/01/2023] [Indexed: 01/23/2024] Open
Abstract
Background Mental health risks associated with the aftermath of the COVID-19 pandemic are often overlooked by the public. The aim of this study was to investigate the effects of the COVID-19 pandemic on depression and anxiety disorders in China. Methods Studies were analyzed and extracted in accordance with the PRISMA 2020 flowchart. The studies were screened and extracted using electronic databases including PubMed, Web of Science, Embase, Cochrane Library, and ClinicalTrials.gov according to the predefined eligibility criteria. The Cochrane Review Manager software 5.3.1 was used for data analysis and the risk of bias assessment. Results As of 2023, a total of 9,212,751 Chinese have been diagnosed with COVID-19 infection. A total of 913,036 participants in 44 studies were selected following the eligibility criteria, the statistical information of which was collected for meta-analysis. The pooled prevalence of depression and anxiety were 0.31 (95% CI: 0.28, 0.35; I2 = 100.0%, p < 0.001) and 0.29 (95% CI: 0.23, 0.36; I2 = 100.0%, p < 0.001), respectively. After performing a subgroup analysis, the prevalence of depression among women, healthcare workers, students, and adolescents was 0.31 (95% CI: 0.22, 0.41), 0.33 (95% CI: 0.26, 0.44), 0.32 (95% CI: 0.26, 0.39), and 0.37 (95% CI: 0.31, 0.44), respectively. Conclusion The prevalence of depression and anxiety among the Chinese was overall high. Monitoring and surveillance of the mental health status of the population during crises such as sudden global pandemics are imperative. Systematic review registration https://clinicaltrials.gov/, identifier [CRD42023402190].
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Affiliation(s)
- Xiang Bin
- Department of Otolaryngology, Fengdu County People's Hospital, Chongqing, China
| | - Ke-Yi Qu
- Department of Stomatology, Fengdu County People's Hospital, Chongqing, China
| | - Yu-Hao Wang
- Shandong Academy of Medical Sciences, Shandong First Medical University, Shandong, China
| | - Li Chen
- Department of Pharmacy, Fengdu County People's Hospital, Chongqing, China
| | - Yan-Jie Xiong
- Department of Pharmacy, Fengdu County People's Hospital, Chongqing, China
| | - Jin Fu Wen
- Institute of Cardiovascular Endocrinology of Shandong First Medical University, Shandong Academy of Medical Sciences, Shandong, China
| | - Hua-Bo Wei
- Department of Pharmacy, Fengdu County People's Hospital, Chongqing, China
| | - Tan Bing
- Department of Pharmacy, Fengdu County People's Hospital, Chongqing, China
| | - Chun-Yan Dan
- Department of Human Resources, Fengdu County People's Hospital, Chongqing, China
| | - Jia-Quan Zhu
- Department of Pharmacy, Fengdu County People's Hospital, Chongqing, China
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Kim N, Anneser E, Chu MT, Nguyen KH, Stopka TJ, Corlin L. Household conditions, COVID-19, and equity: Insight from two nationally representative surveys. RESEARCH SQUARE 2023:rs.3.rs-3129530. [PMID: 37461724 PMCID: PMC10350171 DOI: 10.21203/rs.3.rs-3129530/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Background With people across the United States spending increased time at home since the emergence of COVID-19, housing characteristics may have an even greater impact on health. Therefore, we assessed associations between household conditions and COVID-19 experiences. Methods We used data from two nationally representative surveys: the Tufts Equity Study (TES; n = 1449 in 2021; n = 1831 in 2022) and the Household Pulse Survey (HPS; n = 147,380 in 2021; n = 62,826 in 2022). In the TES, housing conditions were characterized by heating/cooling methods; smoking inside the home; visible water damage/mold; age of housing unit; and self-reported concern about various environmental factors. In TES and HPS, household size was assessed. Accounting for sampling weights, we examined associations between each housing exposure and COVID-19 outcomes (diagnosis, vaccination) using separate logistic regression models with covariates selected based on an evidence-based directed acyclic graph. Results Having had COVID-19 was more likely among people who reported poor physical housing condition (odds ratio [OR] = 2.32; 95% confidence interval [CI] = 1.17-4.59; 2021), visible water damage or mold/musty smells (OR = 1.50; 95% CI = 1.10-2.03; 2022), and larger household size (5+ versus 1-2 people; OR = 1.53, 95% CI = 1.34-1.75, HPS 2022). COVID-19 vaccination was less likely among participants who reported smoke exposure inside the home (OR = 0.53; 95% CI = 0.31-0.90; 2022), poor water quality (OR = 0.42; 95% CI = 0.21-0.85; 2021), noise from industrial activity/construction (OR = 0.44; 95% CI = 0.19-0.99; 2022), and larger household size (OR = 0.57; 95% CI = 0.46-0.71; HPS 2022). Vaccination was also positively associated with poor indoor air quality (OR = 1.96; 95% CI = 1.02-3.72; 2022) and poor physical housing condition (OR = 2.27; 95% CI = 1.01-5.13; 2022). Certain heating/cooling sources were associated with COVID-19 outcomes. Conclusions Our study found poor housing conditions associated with increased COVID-19 burden, which may be driven by systemic disparities in housing, healthcare, and financial access to resources during the COVID-19 pandemic.
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Abi Zeid Daou C, Yammine Y, Daou AM, A R Feghali P, Najjar W, Barazi R. Incidence of pediatric tonsillitis, otitis and upper respiratory infectious entities in the pre and post COVID-19 quarantine eras. Acta Otolaryngol 2023; 143:423-428. [PMID: 37093858 DOI: 10.1080/00016489.2023.2200851] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND At this point of the COVID-19 pandemic, with the worldwide loosening of health restrictions, there has been an observed jump in infectious load especially of the upper airways.Aims/Objectives: To shed light on children's immunity and potential health risks after the COVID-19 pandemic. METHODS A retrospective chart review from May 2019 to January 2022. Pediatric patients with a discharge diagnosis suggestive of an upper respiratory or ENT infection were included. The sample was divided into three groups according to the date of presentation. RESULTS A total 4356 patients were diagnosed with ENT infectious aetiology. The mean age was 4.69 years. The three periods studied were: Period-1 (May 2019-January 2020), period-2 (February 2020-April 2021) and period-3 (May 2021-January 2022). The distribution of adenoiditis and MEE is the same across all periods (p > .05). The incidence of URTI, AOM and tonsillitis were significantly highest during period-3 followed by period-1, which in turn was significantly higher than during period-2 (p < .05). The incidence of sinusitis was the highest during period-3 (p < .001). CONCLUSION There seems to be a heightened susceptibility to acute infection in children after the pandemic.Significance: It is important to keep in mind the changes in microbiota and implement measures to promote healthy gut flora, timely vaccination, and prompt medical interventions.Summary BoxWhat is already known: We already know that quarantine has significantly decreased infectious load especially in children.This study adds an objective assessment of this decrease with an assessment of the infectious load post-quarantine.This study is a model for future pandemics on the importance of vaccinations and the importance of microbiota changes after pandemics.
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Affiliation(s)
- Christophe Abi Zeid Daou
- Department of Otolaryngology & Head and Neck Surgery, American University of Beirut, Beirut, Lebanon
| | - Yara Yammine
- Department of Otolaryngology & Head and Neck Surgery, American University of Beirut, Beirut, Lebanon
| | - Anne-Marie Daou
- Department of Otolaryngology & Head and Neck Surgery, American University of Beirut, Beirut, Lebanon
| | | | | | - Randa Barazi
- Department of Otolaryngology & Head and Neck Surgery, American University of Beirut, Beirut, Lebanon
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Cormier SA, Yamamoto A, Short KR, Vu L, Suk WA. Environmental Impacts on COVID-19: Mechanisms of Increased Susceptibility. Ann Glob Health 2022; 88:94. [PMID: 36348703 PMCID: PMC9585976 DOI: 10.5334/aogh.3907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/28/2022] [Indexed: 11/20/2022] Open
Abstract
Background Since 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in >554M cases and >6.3M deaths worldwide. The disease caused by SARS-CoV-2, COVID-19, has resulted in a broad range of clinical symptoms differing in severity. Initially, the elderly were identified as particularly susceptible to severe COVID-19, with children experiencing less severe disease. However, as new variants arise, the epidemiology of SARS-CoV-2 infection is changing, and the disease severity in children is increasing. While environmental impacts on COVID-19 have been described, the underlying mechanisms are poorly described. Objective The Pacific Basin Consortium for Environment and Health (PBC) held meeting on September 16, 2021, to explore environmental impacts on infectious diseases, including COVID-19. Methods The PBC is an international group of environmental scientists and those interested in health outcomes. The PBC met to present preliminary data and discuss the role of exposures to airborne pollutants in enhancing susceptibility to and severity of respiratory tract viral infections, including COVID-19. Findings Analysis of the literature and data presented identified age as an important factor in vulnerability to air pollution and enhanced COVID-19 susceptibility and severity. Mechanisms involved in increasing severity of COVID-19 were discussed, and gaps in knowledge were identified. Conclusions Exposure to particulate matter (PM) pollution enhanced morbidity and mortality to COVID-19 in a pediatric population associated with induction of oxidative stress. In addition, free radicals present on PM can induce rapid changes in the viral genome that can lead to vaccine escape, altered host susceptibility, and viral pathogenicity. Nutritional antioxidant supplements have been shown to reduce the severity of viral infections, inhibit the inflammatory cytokine storm, and boost host immunity and may be of benefit in combating COVID-19.
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Affiliation(s)
- Stephania A. Cormier
- Louisiana State University, Department of Biological Sciences, and Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Ayaho Yamamoto
- The University of Queensland, Child Health Research Centre, South Brisbane, QLD, Australia
| | - Kirsty R. Short
- The University of Queensland, School of Chemistry and Molecular Biosciences, Brisbane, QLD, Australia
| | - Luan Vu
- Louisiana State University, Department of Biological Sciences, and Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - William A. Suk
- National Institute of Environmental Health Sciences, Superfund Research Program, 530 Davis Drive, Durham, NC, USA
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Clerbaux LA, Albertini MC, Amigó N, Beronius A, Bezemer GFG, Coecke S, Daskalopoulos EP, del Giudice G, Greco D, Grenga L, Mantovani A, Muñoz A, Omeragic E, Parissis N, Petrillo M, Saarimäki LA, Soares H, Sullivan K, Landesmann B. Factors Modulating COVID-19: A Mechanistic Understanding Based on the Adverse Outcome Pathway Framework. J Clin Med 2022; 11:4464. [PMID: 35956081 PMCID: PMC9369763 DOI: 10.3390/jcm11154464] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 12/10/2022] Open
Abstract
Addressing factors modulating COVID-19 is crucial since abundant clinical evidence shows that outcomes are markedly heterogeneous between patients. This requires identifying the factors and understanding how they mechanistically influence COVID-19. Here, we describe how eleven selected factors (age, sex, genetic factors, lipid disorders, heart failure, gut dysbiosis, diet, vitamin D deficiency, air pollution and exposure to chemicals) influence COVID-19 by applying the Adverse Outcome Pathway (AOP), which is well-established in regulatory toxicology. This framework aims to model the sequence of events leading to an adverse health outcome. Several linear AOPs depicting pathways from the binding of the virus to ACE2 up to clinical outcomes observed in COVID-19 have been developed and integrated into a network offering a unique overview of the mechanisms underlying the disease. As SARS-CoV-2 infectibility and ACE2 activity are the major starting points and inflammatory response is central in the development of COVID-19, we evaluated how those eleven intrinsic and extrinsic factors modulate those processes impacting clinical outcomes. Applying this AOP-aligned approach enables the identification of current knowledge gaps orientating for further research and allows to propose biomarkers to identify of high-risk patients. This approach also facilitates expertise synergy from different disciplines to address public health issues.
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Affiliation(s)
- Laure-Alix Clerbaux
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| | | | - Núria Amigó
- Biosfer Teslab SL., 43204 Reus, Spain;
- Department of Basic Medical Sciences, Universitat Rovira i Virgili (URV), 23204 Reus, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Anna Beronius
- Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden;
| | - Gillina F. G. Bezemer
- Impact Station, 1223 JR Hilversum, The Netherlands;
- Department of Pharmaceutical Sciences, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands
| | - Sandra Coecke
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| | - Evangelos P. Daskalopoulos
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| | - Giusy del Giudice
- Finnish Hub for Development and Validation of Integrated Approaches (FHAIVE), Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland; (G.d.G.); (D.G.); (L.A.S.)
| | - Dario Greco
- Finnish Hub for Development and Validation of Integrated Approaches (FHAIVE), Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland; (G.d.G.); (D.G.); (L.A.S.)
| | - Lucia Grenga
- Département Médicaments et Technologies pour la Santé (DMTS), Université Paris-Saclay, CEA, INRAE, SPI, F-30200 Bagnols-sur-Ceze, France;
| | - Alberto Mantovani
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Amalia Muñoz
- European Commission, Joint Research Centre (JRC), 2440 Geel, Belgium;
| | - Elma Omeragic
- Faculty of Pharmacy, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina;
| | - Nikolaos Parissis
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| | - Mauro Petrillo
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
| | - Laura A. Saarimäki
- Finnish Hub for Development and Validation of Integrated Approaches (FHAIVE), Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland; (G.d.G.); (D.G.); (L.A.S.)
| | - Helena Soares
- Laboratory of Immunobiology and Pathogenesis, Chronic Diseases Research Centre, Faculdade de Ciências Médicas Medical School, University of Lisbon, 1649-004 Lisbon, Portugal;
| | - Kristie Sullivan
- Physicians Committee for Responsible Medicine, Washington, DC 20016, USA;
| | - Brigitte Landesmann
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (S.C.); (E.P.D.); (N.P.); (M.P.); (B.L.)
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Sarah RH, Shariful Islam M, Zamiur Rahaman M, Afrin S, Rahman M, Saif-Ur-Rahman KM. Pivotal role of environmental toxicants on developing infectious diseases in LMICs: a protocol for a systematic review and meta-analysis. BMJ Open 2022; 12:e058927. [PMID: 35798518 PMCID: PMC9263937 DOI: 10.1136/bmjopen-2021-058927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Environmental toxicants such as chemical pollution have an enormous impact on the health of people and the planet. Emerging findings suggest that non-communicable diseases are linked to early and chronic environmental exposures. However, the rapid globalisation in developing countries, environmental change and the emergence, spread, persistence and severity of infectious diseases are not yet well understood. The aim of this study is to understand which environmental toxicants are commonly associated with infectious diseases in low-income and middle-income countries (LMICs). METHODS AND ANALYSIS A total of four electronic databases, MEDLINE through PubMed, Scopus, Web of Science and CENTRAL (the Cochrane Library) be searched to identify relevant studies and will be screened by two independent reviewers. The Cochrane risk of bias (ROB) tool for randomised control trials (RCTs) and ROB assessment tool for non-randomised studies for non-RCTs will be used to assess the ROB. A meta-analysis will be used to determine the pooled effect if we find out the included articles have similar environmental exposure, participant groups, study design and outcome measures. A narrative synthesis of the findings will be provided, along with summaries of the intervention effect. Heterogeneity between the studies will be assessed, and sensitivity analysis will be conducted based on study quality. ETHICS AND DISSEMINATION Findings will be summarised in a single manuscript. This review attempts to explore the pivotal role of environmental toxicants in predisposing, developing, persistent and severity of infectious diseases in LMICs. Findings from this study will highlight the effects of individual environmental toxicants' role on infectious disease outcomes for the early prevention and limit toxic exposure to guide individual, community, and occupational health policy for future strategies. PROSPERO REGISTRATION NUMBER CRD42021274359.
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Affiliation(s)
- Rehnuma Haque Sarah
- Environmental Interventions Unit, Infectious Diseases Division, icddr,b: International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh
- School of Medicine, Stanford University, Stanford, California, USA
| | - Md Shariful Islam
- Environmental Interventions Unit, Infectious Diseases Division, icddr,b: International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh
| | - Md Zamiur Rahaman
- Environmental Interventions Unit, Infectious Diseases Division, icddr,b: International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh
| | - Sadia Afrin
- Health Systems and Population Studies Division, ICDDRB, Dhaka, Bangladesh
| | - Mahbubur Rahman
- Environmental Interventions Unit, Infectious Diseases Division, icddr,b: International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh
| | - K M Saif-Ur-Rahman
- Health Systems and Population Studies Division, ICDDRB, Dhaka, Bangladesh
- College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Ireland
- Evidence Synthesis Ireland and Cochrane Ireland, Galway, Ireland
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Epigenetics at the Intersection of COVID-19 Risk and Environmental Chemical Exposures. Curr Environ Health Rep 2022; 9:477-489. [PMID: 35648356 PMCID: PMC9157479 DOI: 10.1007/s40572-022-00353-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Several environmental contaminants have been implicated as contributors to COVID-19 susceptibility and severity. Immunomodulation and epigenetic regulation have been hypothesized as mediators of this relationship, but the precise underlying molecular mechanisms are not well-characterized. This review examines the evidence for epigenetic modification at the intersection of COVID-19 and environmental chemical exposures. RECENT FINDINGS Numerous environmental contaminants including air pollutants, toxic metal(loid)s, per- and polyfluorinated substances, and endocrine disrupting chemicals are hypothesized to increase susceptibility to the SARS-CoV-2 virus and the risk of severe COVID-19, but few studies currently exist. Drawing on evidence that many environmental chemicals alter the epigenetic regulation of key immunity genes and pathways, we discuss how exposures likely perturb host antiviral responses. Specific mechanisms vary by contaminant but include general immunomodulation as well as regulation of viral entry and recognition, inflammation, and immunologic memory pathways, among others. Associations between environmental contaminants and COVID-19 are likely mediated, in part, by epigenetic regulation of key immune pathways involved in the host response to SARS-CoV-2.
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Cheng CY, Tseng YL, Huang KC, Chiu IM, Pan HY, Cheng FJ. Association between Ambient Air Pollution and Emergency Room Visits for Pediatric Respiratory Diseases: The Impact of COVID-19 Pandemic. TOXICS 2022; 10:toxics10050247. [PMID: 35622660 PMCID: PMC9146083 DOI: 10.3390/toxics10050247] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 02/05/2023]
Abstract
The level and composition of air pollution have changed during the coronavirus disease 2019 (COVID-19) pandemic. However, the association between air pollution and pediatric respiratory disease emergency department (ED) visits during the COVID-19 pandemic remains unclear. The study was retrospectively conducted between 2017 and 2020 in Kaohsiung, Taiwan, from 1 January 2020 to 1 May 2020, defined as the period of the COVID-19 pandemic, and 1 January 2017 to 31 May 2019, defined as the pre-COVID-19 pandemic period. We enrolled patients under 17 years old who visited the ED in a medical center and were diagnosed with respiratory diseases such as pneumonia, asthma, bronchitis, and acute pharyngitis. Measurements of particulate matter (PM) with aerodynamic diameters of <10 μm (PM10) and < 2.5 μm (PM2.5), nitrogen dioxide (NO2), and Ozone (O3) were collected. During the COVID-19 pandemic, an increase in the interquartile range of PM2.5, PM10, and NO2 levels was associated with increases of 72.5% (95% confidence interval [CI], 50.5−97.7%), 98.0% (95% CI, 70.7−129.6%), and 54.7% (95% CI, 38.7−72.6%), respectively, in the risk of pediatric respiratory disease ED visits on lag 1, which were greater than those in the pre-COVID-19 pandemic period. After adjusting for temperature and humidity, the risk of pediatric respiratory diseases after exposure to PM2.5 (inter p = 0.001) and PM10 (inter p < 0.001) was higher during the COVID-19 pandemic. PM2.5, PM10, and NO2 may play important roles in pediatric respiratory events in Kaohsiung, Taiwan. Compared with the pre-COVID-19 pandemic period, the levels of PM2.5 and PM10 were lower; however, the levels were related to a greater increase in ED during the COVID-19 pandemic.
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Affiliation(s)
- Chi-Yung Cheng
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan; (C.-Y.C.); (K.-C.H.); (I.-M.C.); (H.-Y.P.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Computer Science and Engineering, National Sun Yat-sen University, 70, Lian-Hai Road, Kaohsiung 804, Taiwan
| | - Yu-Lun Tseng
- Institute of Environmental Engineering, National Sun Yat-sen University, 70, Lian-Hai Road, Kaohsiung 804, Taiwan;
| | - Kuo-Chen Huang
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan; (C.-Y.C.); (K.-C.H.); (I.-M.C.); (H.-Y.P.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - I-Min Chiu
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan; (C.-Y.C.); (K.-C.H.); (I.-M.C.); (H.-Y.P.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Computer Science and Engineering, National Sun Yat-sen University, 70, Lian-Hai Road, Kaohsiung 804, Taiwan
| | - Hsiu-Yung Pan
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan; (C.-Y.C.); (K.-C.H.); (I.-M.C.); (H.-Y.P.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Fu-Jen Cheng
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan; (C.-Y.C.); (K.-C.H.); (I.-M.C.); (H.-Y.P.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Correspondence: ; Tel.: +886-975056646; Fax: +886-7-7317123
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Weaver AK, Head JR, Gould CF, Carlton EJ, Remais JV. Environmental Factors Influencing COVID-19 Incidence and Severity. Annu Rev Public Health 2022; 43:271-291. [PMID: 34982587 PMCID: PMC10044492 DOI: 10.1146/annurev-publhealth-052120-101420] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Emerging evidence supports a link between environmental factors-including air pollution and chemical exposures, climate, and the built environment-and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and coronavirus disease 2019 (COVID-19) susceptibility and severity. Climate, air pollution, and the built environment have long been recognized to influence viral respiratory infections, and studies have established similar associations with COVID-19 outcomes. More limited evidence links chemical exposures to COVID-19. Environmental factors were found to influence COVID-19 through four major interlinking mechanisms: increased risk of preexisting conditions associated with disease severity; immune system impairment; viral survival and transport; and behaviors that increase viral exposure. Both data and methodologic issues complicate the investigation of these relationships, including reliance on coarse COVID-19 surveillance data; gaps in mechanistic studies; and the predominance of ecological designs. We evaluate the strength of evidence for environment-COVID-19 relationships and discuss environmental actions that might simultaneously address the COVID-19 pandemic, environmental determinants of health, and health disparities.
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Affiliation(s)
- Amanda K Weaver
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, USA; ,
| | - Jennifer R Head
- Department of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California, USA;
| | - Carlos F Gould
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA;
- Department of Earth System Science, Stanford University, Stanford, California, USA
| | - Elizabeth J Carlton
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz, Aurora, Colorado, USA;
| | - Justin V Remais
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, USA; ,
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Cheng FK. Debate on mandatory COVID-19 vaccination. ETHICS, MEDICINE, AND PUBLIC HEALTH 2022; 21:100761. [PMID: 35097181 PMCID: PMC8784578 DOI: 10.1016/j.jemep.2022.100761] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/17/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Since January 2020, worldwide public health has been threatened by COVID-19, for which vaccines have been adopted from December 2020. DISCUSSION Although vaccines demonstrate effectiveness against this disease, vaccine hesitancy reveals concerns towards short-term and long-term side effects or adverse reactions such as post-inoculation death. Mandatory vaccination is used to provide herd immunity, but is refutable due to infringement of human rights and autonomy. Furthermore, the evidence testifies that vaccination cannot guarantee prevention of infection or re-infection, resulting in public resentment against this coercive measure, whilst post-inoculation anxiety continues. PERSPECTIVE This discussion suggests a holistic approach, involving the collective efforts of governments, medical experts and individuals, through basic preventive measures and alternative therapy to live with COVID-19 in a healthy and resourceful manner.
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Veronesi G, De Matteis S, Calori G, Pepe N, Ferrario MM. Long-term exposure to air pollution and COVID-19 incidence: a prospective study of residents in the city of Varese, Northern Italy. Occup Environ Med 2022; 79:192-199. [PMID: 35012995 PMCID: PMC8764713 DOI: 10.1136/oemed-2021-107833] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 12/09/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To investigate the association between long-term exposure to airborne pollutants and the incidence of SARS-CoV-2 up to March 2021 in a prospective study of residents in Varese city. METHODS Citizens of Varese aged ≥18 years as of 31 December 2019 were linked by residential address to 2018 average annual exposure to outdoor concentrations of PM2.5, PM10, NO2, NO and ozone modelled using the Flexible Air quality Regional Model (FARM) chemical transport model. Citizens were further linked to regional datasets for COVID-19 case ascertainment (positive nasopharyngeal swab specimens) and to define age, sex, living in a residential care home, population density and comorbidities. We estimated rate ratios and additional numbers of cases per 1 µg/m3 increase in air pollutants from single- and bi-pollutant Poisson regression models. RESULTS The 62 848 residents generated 4408 cases. Yearly average PM2.5 exposure was 12.5 µg/m3. Age, living in a residential care home, history of stroke and medications for diabetes, hypertension and obstructive airway diseases were independently associated with COVID-19. In single-pollutant multivariate models, PM2.5 was associated with a 5.1% increase in the rate of COVID-19 (95% CI 2.7% to 7.5%), corresponding to 294 additional cases per 100 000 person-years. The association was confirmed in bi-pollutant models; excluding subjects in residential care homes; and further adjusting for area-based indicators of socioeconomic level and use of public transportation. Similar findings were observed for PM10, NO2 and NO. Ozone was associated with a 2% decrease in disease rate, the association being reversed in bi-pollutant models. CONCLUSIONS Long-term exposure to low levels of air pollutants, especially PM2.5, increased the incidence of COVID-19. The causality warrants confirmation in future studies; meanwhile, government efforts to further reduce air pollution should continue.
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Affiliation(s)
- Giovanni Veronesi
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | | | - Marco M Ferrario
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
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