COVID-19 morbidity in lower versus higher income populations underscores the need to restore lost biodiversity of eukaryotic symbionts

Demography, sanitation and previous disease prevalence associate with COVID-19 deaths across Indian States

The severity of COVID-19 has varied across regions, with a disproportionately higher case-fatality ratio in developed nations. In India, states with higher income have reported more COVID-19 related deaths compared to lower-income states. Understanding the underlying factors such as demographics, disease burden, urbanization, and sanitation can help in designing better public health policies to mitigate future pandemics. The objective of this study is to identify key predictors of COVID-19 mortality across Indian states by examining the role of disease prevalence, demographics, urbanization, and sanitation. We analysed data from the Global Burden of Diseases India 2019 and the National Health Profile 2019, correlating them with COVID-19 mortality during two peak periods of the pandemic. Spearman correlation analysis and multivariate regression models were employed to determine significant associations and build predictive models for COVID-19 deaths. Our analysis showed a positive correlation between COVID-19 mortality and demographic factors such as the percentage of the elderly population (ρ = 0.44, p < 0.05 for the first peak; ρ = 0.46, p < 0.05 for the second peak). Urbanization was also significantly associated with higher mortality (ρ = 0.71, p < 0.05 for the first peak; ρ = 0.57, p < 0.05 for the second peak). Additionally, the prevalence of autoimmune diseases and cancer correlated positively with deaths. An unexpected finding was the positive correlation between improved sanitation (e.g., closed drainage systems and indoor toilets) and COVID-19 mortality. The best-fit multivariate regression model, combining demographics, sanitation, autoimmune diseases, and cancer, achieved an adjusted R2 of 0.71 for the first peak and 0.85 for the second peak. Our findings suggest that as states become wealthier, they undergo urbanization and infrastructural improvements, including better sanitation. However, these changes may also be associated with a rise in autoimmune diseases and cancer, potentially reducing immune resilience to emerging infections. This study provides novel insights into how improved living conditions and lifestyle changes may paradoxically contribute to increased COVID-19 mortality. By emphasizing the role of immune training in pandemic preparedness, our research offers a new perspective on public health strategies for mitigating future infectious disease outbreaks.

Reevaluating Biota Alteration: Reframing Environmental Influences on Chronic Immune Disorders and Exploring Novel Therapeutic Opportunities

Environmental mismatches are defined as changes in the environment that induce public health crises. Well known mismatches leading to chronic disease include the availability of technologies that facilitate unhealthy diets and sedentary lifestyles, both factors that adversely affect cardiovascular health. This commentary puts these mismatches in context with biota alteration, an environmental mismatch involving hygiene-related technologies necessary for avoidance of infectious disease. Implementation of hygiene-related technologies causes a loss of symbiotic helminths and protists, profoundly affecting immune function and facilitating a variety of chronic conditions, including allergic disorders, autoimmune diseases, and several inflammation-associated neuropsychiatric conditions. Unfortunately, despite an established understanding of the biology underpinning this and other environmental mismatches, public health agencies have failed to stem the resulting tide of increased chronic disease burden. Both biomedical research and clinical practice continue to focus on an ineffective and reactive pharmaceutical-based paradigm. It is argued that the healthcare of the future could take into account the biology of today, effectively and proactively dealing with environmental mismatch and the resulting chronic disease burden.

The Dangers of Acetaminophen for Neurodevelopment Outweigh Scant Evidence for Long-Term Benefits

Based on available data that include approximately 20 lines of evidence from studies in laboratory animal models, observations in humans, correlations in time, and pharmacological/toxicological considerations, it has been concluded without reasonable doubt and with no evidence to the contrary that exposure of susceptible babies and children to acetaminophen (paracetamol) induces many, if not most, cases of autism spectrum disorder (ASD). However, the relative number of cases of ASD that might be induced by acetaminophen has not yet been estimated. Here, we examine a variety of evidence, including the acetaminophen-induced reduction of social awareness in adults, the prevalence of ASD through time, and crude estimates of the relative number of ASD cases induced by acetaminophen during various periods of neurodevelopment. We conclude that the very early postpartum period poses the greatest risk for acetaminophen-induced ASD, and that nearly ubiquitous use of acetaminophen during early development could conceivably be responsible for the induction in the vast majority, perhaps 90% or more, of all cases of ASD. Despite over a decade of accumulating evidence that acetaminophen is harmful for neurodevelopment, numerous studies demonstrate that acetaminophen is frequently administered to children in excess of currently approved amounts and under conditions in which it provides no benefit. Further, studies have failed to demonstrate long-term benefits of acetaminophen for the pediatric population, leaving no valid rationale for continued use of the drug in that population given its risks to neurodevelopment.