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Sahebari M, Esmailpour M, Esmaili H, Orooji A, Dowlatabadi Y, Nabavi Mahali S, Rajabi E, Salari M. Influence of Air Pollutants on the Disease Activity and Quality of Life in Rheumatoid Arthritis, an Iranian Observational Longitudinal Study. Med J Islam Repub Iran 2023; 37:65. [PMID: 37745016 PMCID: PMC10513401 DOI: 10.47176/mjiri.37.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Indexed: 09/26/2023] Open
Abstract
Background Environmental exposures and genetic predisposition interactions may result in autoimmune rheumatic diseases. This study aimed to determine the effect of outdoor air pollutants on the activity of rheumatoid arthritis (RA) in a longitudinal follow-up. Methods We longitudinally studied 50 patients with RA bimonthly over 6 months in Mashhad, one of the most polluted cities in Iran. Disease activity and health-related quality of life (HRQoL) were examined according to the disease activity score (DAS28ESR), health assessment questionnaires (HAQ), physical health component summary (PCS), and visual analogue scale (VAS) criteria. The outdoor air pollutant was measured by monitoring the average concentration of nitrogen oxide (NO), carbon monoxide (CO), O2 level, Sulfur dioxide (SO2), and some particles less than 10 and 2.5 micrometers in diameter (PM <10 µm, PM <2.5 µm). The temperature and humidity levels were also measured. The univariate and multivariate statistical analyses were used for data analysis and the role of confounding factors was determined using the generalized estimation equation method. Results Statistical analysis indicated a significant increase of the DAS28ESR (B = 0.04 [0.08]; P = 0.01) and VAS (B = 4.48 [1.73]; P = 0.01) by CO concentration. Moreover, a number of polluted days increased the VAS in patients. In addition, other air pollutants, temperature, and humidity were not affected significantly by the DAS28ESR and quality of life indexes by considering confounders such as medications, age, and job. Conclusion Based on our findings, CO concentration was the only effective outdoor air pollutant that could increase RA disease activity. In addition, CO concentration and the number of polluted days make patients feel more ill. As the role of indoor air pollutants is highly important, further research on this critical topic is required to establish the role of air pollution on RA disease activity.
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Affiliation(s)
- Maryam Sahebari
- Rheumatic Diseases Research Center, Mashhad University of Medical
Sciences, Mashhad, Iran
| | - Maryam Esmailpour
- School of Medicine, Mashhad University of Medical Sciences, Mashhad,
Iran
| | - Habibollah Esmaili
- Social Determinates of Health Research Center, Mashhad University of
Medical Sciences, Mashhad, Iran
| | - Arezoo Orooji
- Social Determinates of Health Research Center, Mashhad University of
Medical Sciences, Mashhad, Iran
| | - Yousef Dowlatabadi
- School of Medicine, Mashhad University of Medical Sciences, Mashhad,
Iran
| | | | - Enayat Rajabi
- Shannon School of Business, Cape Berton University, Sydney, NS, Canada
| | - Masoumeh Salari
- Rheumatic Diseases Research Center, Mashhad University of Medical
Sciences, Mashhad, Iran
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Seddigh-Shamsi M, Nabavi Mahali S, Mozdourian M, Allahyari A, Saeedian N, Emadzade M, Ebrahimzadeh F, Javidarabshahi Z, Khatami S, Akbari Rad M, Ravanshad S, Naghavi M, Mozaheb Z, Moeini Nodeh M, Rahimi H, Bary A, Kamandi M, Ataei Azimi S, Yaghoubi MA, Rezaei Borojerdi Z. Investigation of hematological parameters related to the severity of COVID-19 disease in Mashhad, Iran. Immunopathol Persa 2020. [DOI: 10.34172/ipp.2021.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction:Human coronavirus disease 2019 (COVID-19) is an emerging respiratory disease that has become pandemic worldwide. The patients have a range of mild to severe symptoms, such as pneumonia, acute respiratory distress syndrome, arrhythmia, shock, and other organs involvement. Clinical and hematological evidence can serve as a prognostic factor to detect severe cases of COVID-19. Objectives: The present study aimed to evaluate hematological parameters related to the severity of the disease in COVID-19 patients in Mashhad, Eastern Iran. Patients and Methods: All the individuals with positive real-time reverse transcription-polymerase chain reaction test results and the patients with clinical symptoms whose computed tomography scan results were matched with the diagnosis of viral pneumonia were included in the study. The hematological examinations and complete blood count of the patients were performed by the healthcare personnel through collecting blood samples at the time of admission and discharge from the hospital. Results: In total, 189 COVID-19 patients were included in the study, 47.6% and 58.73% of whom were over 60 years old and male, respectively. Investigation of the hematological parameters revealed that the number of white blood cells, mean value of corpuscular volume, number of platelets, and lymph count had significantly increased at the time of discharge (P<0.01). On the other hand, red blood cells, hemoglobin, hematocrit, mean corpuscular hemoglobin, mean corpuscular hemoglobin, and red cell distribution width values were significantly higher at the time of admission in comparison to discharge (P<0.01). Furthermore, it was found that male gender had a significant relationship with the development of lymphopenia in the patients (P=0.021). Conclusion: It can be concluded that hematological parameters and inflammatory biomarkers in COVID-19 patients could potentially act as the independent factors and affect the prognosis of the disease.
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Affiliation(s)
- Mohsen Seddigh-Shamsi
- Department of Hematology Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shima Nabavi Mahali
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahnaz Mozdourian
- Lung Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abolghasem Allahyari
- Department of Hematology Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Neda Saeedian
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Emadzade
- Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farnoosh Ebrahimzadeh
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Javidarabshahi
- Lung Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shohre Khatami
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mina Akbari Rad
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sahar Ravanshad
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Naghavi
- Internal Medicine Resident, Internal Medicine Department, Imam Reza Hospital, Mashhad University of Medical sciences, Mashhad, Iran
| | - Zahra Mozaheb
- Department of Hematology Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Moeini Nodeh
- Department of Hematology Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Rahimi
- Department of Hematology Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Bary
- Department of Hematology Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mostafa Kamandi
- Department of Hematology Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sajad Ataei Azimi
- Department of Hematology Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Ali Yaghoubi
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Rezaei Borojerdi
- Department of Hematology Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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