Effects of short-term and long-term exposure to ambient air pollution and temperature on long recovery duration in COVID-19 patients

Effects of early-life air pollution exposure on childhood COVID-19 infection and sequelae in China

BACKGROUND

While ambient air pollution has been associated with COVID-19 outcomes, the role of early-life exposure in childhood COVID-19 infection and sequelae remains unexplored.

OBJECTIVES

To assess the associations between early-life exposure to ambient air pollutants during and childhood COVID-19 infection and sequelae.

METHODS

This cross-sectional retrospective cohort study surveyed families with children aged 3-6 years in families across nine Chinese cities between December 2019 and May 2023. The primary outcomes were doctor-diagnosed childhood COVID-19 infection and sequelae. Individual exposure to PM2.5, PM2.5-10, PM10, SO2, NO2, CO, O3, and temperature were estimated.

RESULTS

Among 20,012 children from 60,036 participants, 5.81 % were diagnosed with COVID-19 infection, and 1.72 % had sequelae. Prenatal CO exposure was associated with higher infection risk (OR: 1.33; 95 % CI: 1.05-1.69 per IQR increase). SO2 exposure during the first trimester (OR: 3.02; 95 % CI: 1.20-7.61), second trimester (OR: 4.00; 95 % CI: 1.56-10.27) and third trimester (OR: 3.84; 95 % CI: 1.69-8.76) of pregnancy and the first year of life (OR: 8.43; 95 % CI: 1.80-39.48) was strongly associated with sequelae. Pre-existing allergies and coarser particulate matter (PM2.5-10 and PM10) amplified these associations. High relative humidity significantly increased the effect of exposure to NO2 during four-six months before pregnancy and the second trimester of pregnancy, as well as O3 exposure during the first year on childhood COVID-19 infection.

CONCLUSIONS

Early-life exposure to air pollutants and interactions with allergic conditions and coarser particles influence childhood COVID-19 risks.

The association between different timeframes of air pollution exposure and COVID-19 incidence, morbidity and mortality in German counties in 2020

BACKGROUND

Ambient air pollution is a known risk factor for several chronic health conditions, including pulmonary dysfunction. In recent years, studies have shown a positive association between exposure to air pollutants and the incidence, morbidity, and mortality of a COVID-19 infection, however the time period for which air pollution exposure is most relevant for the COVID-19 outcome is still not defined. The aim of this study was to analyze the difference in association when varying the time period of air pollution exposure considered on COVID-19 infection within the same cohort during the first wave of the pandemic in 2020.

METHODS

We conducted a cross-sectional study analyzing the association between long- (10- and 2-years) and short-term (28 days, 7 days, and 2 days) exposure to NO2 and PM2.5 on SARS-CoV-2 incidence, morbidity, and mortality at the level of county during the first outbreak of the pandemic in spring 2020. Health data were extracted from the German national public health institute (Robert-Koch-Institute) and from the German Interdisciplinary Association for Intensive Care and Emergency Medicine. Air pollution data were taken from the APExpose dataset (version 2.0). We used negative binomial models, including adjustment for risk factors (age, sex, days since first COVID-19 case, population density, socio-economic and health parameters).

RESULTS

We found that PM2.5 and NO2 exposure 28 days before COVID-19 infection had the highest association with infection, morbidity as well as mortality, as compared to long-term or short-term (2 or 7 days) air pollutant exposure. A 1 μg/m3 increase in PM2.5 was associated with a 31.7% increase in incidence, a 20.6% need for ICU treatment, a 23.1% need for mechanical ventilation, and a 55.3% increase in mortality; an increase of 1 μg/m3 of NO2 was associated with an increase for all outcomes by 25.2 - 29.4%.

CONCLUSIONS

Our findings show a positive association between PM2.5 and NO2 exposure and the clinical course of a SARS-CoV2 infection, with the strongest association to 28 days of exposure to air pollution. This finding provides an indication as to the primary underlying pathophysiology, and can therefore help to improve the resilience of societies by implementing adequate measures to reduce the air pollutant impact on health outcomes.

TRIAL REGISTRATION

Not applicable.

Diurnal temperature range and hypertension: cross-sectional and longitudinal findings from the China Health and Retirement Longitudinal Study (CHARLS)

BACKGROUND

Research indicates a positive association between short-term diurnal temperature range (DTR) exposure and hypertension. However, the impact of long-term DTR exposure has not been thoroughly studied in population-based cohort research.

METHODS

This study conducted cross-sectional (including 16,690 participants) and longitudinal analyses (including 9,650 participants) based on the China Health and Retirement Longitudinal Study (CHARLS). Daily temperature data was sourced from the National Scientific Data of the Qinghai-Tibet Plateau. We calculated the moving average of DTR exposure of all the participants in CHARLS with exposure windows of 30-day, 60-day, 180-day, 1-year, and 2-year before the interview month of CHARLS Wave1 (2011). Logistic regression and age-stratified Cox proportional hazards models were employed in our analysis.

RESULTS

In the cross-sectional study, 6,572 (39.4%) participants had hypertension. We found higher DTR is associated with a higher prevalence of hypertension across different exposure windows. The effect was strongest when the exposure window of DTR was 180-day, with an adjusted odds ratio (OR) of 1.261 (95% confidence interval (CI): 1.124-1.416 [highest tertile DTR vs. lowest tertile DTR]). In the cohort study, 3,020 (31.3%) participants developed hypertension during 83 months of follow-up. A higher level of DTR (hazard ratio (HR): 1.224, 95% CI: 1.077-1.391) was associated with a higher risk of incident hypertension. We found significant interactions between DTR and age (P interaction: <0.001) and residence (P interaction: 0.045).

CONCLUSION

We found significant positive associations between DTR and prevalent and incident hypertension. Individuals younger than 65 and those living in rural areas are at an elevated risk of developing hypertension due to DTR.

Natural and socio-environmental factors in the transmission of COVID-19: a comprehensive analysis of epidemiology and mechanisms

PURPOSE OF REVIEW

There are significant differences in the transmission rate and mortality rate of COVID-19 under environmental conditions such as seasons and climates. However, the impact of environmental factors on the role of the COVID-19 pandemic and the transmission mechanism of the SARS-CoV-2 is unclear. Therefore, a comprehensive understanding of the impact of environmental factors on COVID-19 can provide innovative insights for global epidemic prevention and control policies and COVID-19 related research. This review summarizes the evidence of the impact of different natural and social environmental factors on the transmission of COVID-19 through a comprehensive analysis of epidemiology and mechanism research. This will provide innovative inspiration for global epidemic prevention and control policies and provide reference for similar infectious diseases that may emerge in the future.

RECENT FINDINGS

Evidence reveals mechanisms by which natural environmental factors influence the transmission of COVID-19, including (i) virus survival and transport, (ii) immune system damage, (iii) inflammation, oxidative stress, and cell death, and (iiii) increasing risk of complications. All of these measures appear to be effective in controlling the spread or mortality of COVID-19: (1) reducing air pollution levels, (2) rational use of ozone disinfection and medical ozone therapy, (3) rational exposure to sunlight, (4) scientific ventilation and maintenance of indoor temperature and humidity, (5) control of population density, and (6) control of population movement. Our review indicates that with the continuous mutation of SARS-CoV-2, high temperature, high humidity, low air pollution levels, and low population density more likely to slow down the spread of the virus.

Association between ambient particulate matter exposure and mitochondrial DNA copy number: A systematic review and meta-analysis

BACKGROUND

Ambient particulate matter (PM) has been recognized as inducing oxidative stress, which could contribute to mitochondrial damage and dysfunction. However, studies investigating the association between ambient PM and mitochondria, particularly mitochondrial DNA copy number (mtDNA-CN), have yielded inconsistent results.

METHODS

We conducted comprehensive literature searches to identify observational studies published before July 17, 2023, examining the association between ambient PM exposure and mtDNA-CN. Meta-analysis using random effects model was employed to calculate the pooled effect estimates for general individual exposures, as well as for prenatal exposure with specific trimester. Additionally, the quality and level of evidence for each exposure-outcome pair was evaluated.

RESULTS

A total of 10 studies were included in the systematic review and meta-analysis. The results indicated that general individual exposure to PM2.5 (β = -0.084, 95 % CI: -0.521, 0.353; I2 = 93 %) and PM10 (β = 0.035, 95 % CI: -0.129, 0.199; I2 = 95 %) did not significantly affect mtDNA-CN. Prenatal exposure to PM2.5 (β = 0.023, 95 % CI: -0.087, 0.133; I2 = 0 %) and PM10 (β = 0.006, 95 % CI: -0.135; 0.147; I2 = 51 %) were also not significantly associated with mtDNA-CN in offspring. The level of evidence for each tested exposure-outcome pair was assessed as "inadequate."

CONCLUSIONS

The findings of this systematic review and meta-analysis indicate that there is an "inadequate" strength of evidence for the association between general individual or prenatal exposure to ambient PM and mtDNA-CN. Future research necessitates studies with more rigorous design, enhanced control of confounding factors, and improved measures of exposure to substantiate our findings.

The impact of ambient temperature and air pollution on SARS-CoV2 infection and Post COVID-19 condition in Belgium (2021-2022)

INTRODUCTION

The associations between non-optimal ambient temperature, air pollution and SARS-CoV-2 infection and post COVID-19 condition (PCC) remain constrained in current understanding. We conducted a retrospective analysis to explore how ambient temperature affected SARS-CoV-2 infection in individuals who later developed PCC compared to those who did not. We investigated if these associations were modified by air pollution.

METHODS

We conducted a bidirectional time-stratified case-crossover study among individuals who tested positive for SARS-CoV-2 between May 2021 and June 2022. We included 6302 infections, with 2850 PCC cases. We used conditional logistic regression and distributed lag non-linear models to obtain odds ratios (OR) and 95% confidence intervals (CI) for non-optimal temperatures relative to the period median temperature (10.6 °C) on lags 0 to 5. For effect modification, daily average PM2.5 concentrations were categorized using the period median concentration (8.8 μg/m3). Z-tests were used to compare the results by PCC status and PM2.5.

RESULTS

Non-optimal cold temperatures increased the cumulative odds of infection (OR = 1.93; 95%CI:1.67-2.23, OR = 3.53; 95%CI:2.72-4.58, for moderate and extreme cold, respectively), with the strongest associations observed for non-PCC cases. Non-optimal heat temperatures decreased the odds of infection except for moderate heat among PCC cases (OR = 1.32; 95%CI:0.89-1.96). When PM2.5 was >8.8 μg/m3, the associations with cold were stronger, and moderate heat doubled the odds of infection with later development of PCC (OR = 2.18; 95%CI:1.01-4.69). When PM2.5 was ≤8.8 μg/m3, exposure to non-optimal temperatures reduced the odds of infection.

CONCLUSION

Exposure to cold increases SARS-CoV2 risk, especially on days with moderate to high air pollution. Heated temperatures and moderate to high air pollution during infection may cause PCC. These findings stress the need for mitigation and adaptation strategies for climate change to reduce increasing trends in the frequency of weather extremes that have consequences on air pollution concentrations.

Environmental Factors Influencing the Dynamics and Evolution of COVID-19: A Systematic Review on the Study of Short-Term Ozone Exposure

The potential influence of environmental factors, particularly air pollutants such as ozone (O3), on the dynamics and progression of COVID-19 remains a significant concern. This study aimed to systematically review and analyze the current body of literature to assess the impact of short-term ozone exposure on COVID-19 transmission dynamics and disease evolution. A rigorous systematic review was conducted in March 2023, covering studies from January 2020 to January 2023 found in PubMed, Web of Science, and Scopus. We followed the PRISMA guidelines and PROSPERO criteria, focusing exclusively on the effects of short-term ozone exposure on COVID-19. The literature search was restricted to English-language journal articles, with the inclusion and exclusion criteria strictly adhered to. Out of 4674 identified studies, 18 fulfilled the inclusion criteria, conducted across eight countries. The findings showed a varied association between short-term ozone exposure and COVID-19 incidence, severity, and mortality. Some studies reported a higher association between ozone exposure and incidence in institutional settings (OR: 1.06, 95% CI: 1.00-1.13) compared to the general population (OR: 1.00, 95% CI: 0.98-1.03). The present research identified a positive association between ozone exposure and both total and active COVID-19 cases as well as related deaths (coefficient for cases: 0.214; for recoveries: 0.216; for active cases: 0.467; for deaths: 0.215). Other studies also found positive associations between ozone levels and COVID-19 cases and deaths, while fewer reports identified a negative association between ozone exposure and COVID-19 incidence (coefficient: -0.187) and mortality (coefficient: -0.215). Conversely, some studies found no significant association between ozone exposure and COVID-19, suggesting a complex and potentially region-specific relationship. The relationship between short-term ozone exposure and COVID-19 dynamics is complex and multifaceted, indicating both positive and negative associations. These variations are possibly due to demographic and regional factors. Further research is necessary to bridge current knowledge gaps, especially considering the potential influence of short-term O3 exposure on COVID-19 outcomes and the broader implications on public health policy and preventive strategies during pandemics.

Long-term spatiotemporal evolution and coordinated control of air pollutants in a typical mega-mountain city of Cheng-Yu region under the "dual carbon" goal

Clarifying the spatiotemporal distribution and impact mechanism of pollution is the prerequisite for megacities to formulate relevant air pollution prevention and control measures and achieve carbon neutrality goals. Chongqing is one of the dual-core key megacities in Cheng-Yu region and as a typical mountain-city in China, environmental problems are complex and sensitive. This research aims to investigate the exceeding standard levels and spatio-temporal evolution of criteria pollutants between 2014 and 2020. The results indicated that PM10, PM2.5, CO and SO2 were decreased significantly by 45.91%, 52.86%, 38.89% and 66.67%, respectively. Conversely, the concentration of pollutant O3 present a fluctuating growth and found a "seesaw" phenomenon between it and PM. Furthermore, PM and O3 are highest in winter and summer, respectively. SO2, NO2, CO, and PM showed a "U-shaped", and O3 showed an inverted "U-shaped" seasonal variation. PM and O3 concentrations are still far behind the WHO, 2021AQGs standards. Significant spatial heterogeneity was observed in air pollution distribution. These results are of great significance for Chongqing to achieve "double control and double reduction" of PM2.5 and O3 pollution, and formulate a regional carbon peaking roadmap under climate coordination. Besides, it can provide an important platform for exploring air pollution in typical terrain around the world and provide references for related epidemiological research.Implications: Chongqing is one of the dual-core key megacities in Cheng-Yu region and as a typical mountain city, environmental problems are complex and sensitive. Under the background of the "14th Five-Year Plan", the construction of the "Cheng-Yu Dual-City Economic Circle" and the "Dual-Carbon" goal, this article comprehensively discussed the annual and seasonal excess levels and spatiotemporal evolution of pollutants under the multiple policy and the newest international standards (WHO,2021AQG) backgrounds from 2014 to 2020 in Chongqing. Furthermore, suggestions and measures related to the collaborative management of pollutants were discussed. Finally, limitations and recommendations were also put forward.Clarifying the spatiotemporal distribution and impact mechanism of pollution is the prerequisite for cities to formulate relevant air pollution control measures and achieve carbon neutrality goals. This study is of great significance for Chongqing to achieve "double control and double reduction" of PM2.5 and O3 pollution, study and formulate a regional carbon peaking roadmap under climate coordination and an action plan for sustained improvement of air quality.In addition, this research can advanced our understanding of air pollution in complex terrain. Furthermore, it also promote the construction of the China national strategic Cheng-Yu economic circle and build a beautiful west. Moreover, it provides scientific insights for local policymakers to guide smart urban planning, industrial layout, energy structure, and transportation planning to improve air quality throughout the Cheng-Yu region. Finally, this is also conducive to future scientific research in other regions of China, and even megacities with complex terrain in the world.

COVID-19 Patterns in Araraquara, Brazil: A Multimodal Analysis

The epidemiology of COVID-19 presented major shifts during the pandemic period. Factors such as the most common symptoms and severity of infection, the circulation of different variants, the preparedness of health services, and control efforts based on pharmaceutical and non-pharmaceutical interventions played important roles in the disease incidence. The constant evolution and changes require the continuous mapping and assessing of epidemiological features based on time-series forecasting. Nonetheless, it is necessary to identify the events, patterns, and actions that were potential factors that affected daily COVID-19 cases. In this work, we analyzed several databases, including information on social mobility, epidemiological reports, and mass population testing, to identify patterns of reported cases and events that may indicate changes in COVID-19 behavior in the city of Araraquara, Brazil. In our analysis, we used a mathematical approach with the fast Fourier transform (FFT) to map possible events and machine learning model approaches such as Seasonal Auto-regressive Integrated Moving Average (ARIMA) and neural networks (NNs) for data interpretation and temporal prospecting. Our results showed a root-mean-square error (RMSE) of about 5 (more precisely, a 4.55 error over 71 cases for 20 March 2021 and a 5.57 error over 106 cases for 3 June 2021). These results demonstrated that FFT is a useful tool for supporting the development of the best prevention and control measures for COVID-19.