Can PM2.5 pollution worsen the death rate due to COVID-19 in India and Pakistan?

Correlates of In-Hospital COVID-19 Deaths: A Competing Risks Survival Time Analysis of Retrospective Mortality Data

INTRODUCTION

Several aspects of the coronavirus disease 2019 (COVID-19) pandemic remain ambiguous, including its transmission, severity, geographic, and racial differences in mortality. These variations merit elaboration of local patterns to inform wider national policies.

METHODS

In a retrospective analysis, data of patients treated at a dedicated COVID hospital with moderate and severe illness during 8 wk of the pandemic were reviewed with attention to mortality in a competing risks framework.

RESULTS

A total of 1147 patients were hospitalized, and 312 (27.2%) died in hospital. Those who died were older (56.5 vs 47.6 y; P < 0.0001). Of these, 885 (77.2%) had tested positive on reverse transcriptase polymerase chain reaction (RT-PCR), with 219 (24.2%) deaths (incidence rate, 1.9 per 100 person-days). Median time from onset of symptoms to death was 11 days. A competing risks analysis for in-hospital death revealed an adjusted cause-specific hazard ratio of 1.4 for each decade increase in age.

CONCLUSIONS

This retrospective analysis provides broad patterns of disease presentation and mortality. Even COVID test-negative patients will receive treatment at dedicated facilities, and 33% presenting cases may die within the first 72 h, most with comorbid illness. This should be considered while planning distribution of services for effective health-care delivery.

The impact of COVID-19 pandemic on air pollution: a global research framework, challenges, and future perspectives

As a result of extreme modifications in human activity during the COVID-19 pandemic, the status of air quality has recently been improved. This bibliometric study was conducted on a global scale to quantify the impact of the COVID-19 pandemic on air pollution, identify the emerging challenges, and discuss the future perspectives during the course of the ongoing COVID-19 pandemic. For this, we have estimated the scientific production trends between 2020 and 2021 and investigated the contributions of countries, institutions, authors, and most prominent journals metrics network analysis on the topic of COVID-19 combined with air pollution research spanning the period between January 01, 2020, and June 21, 2021. The search strategy retrieved a wide range of 2003 studies published in scientific journals from the Web of Sciences Core Collection (WoSCC). The findings indicated that (1) publications on COVID-19 pandemic and air pollution were 990 (research articles) in 2021 with 1870 citations; however, the year 2020 witnessed only 830 research articles with a large number 16,600 of citations. (2) China ranked first in the number of publications (n = 365; 18.22% of the global output) and was the main country in international cooperation network, followed by the USA (n = 278; 13.87% of the global output) and India (n = 216; 10.78 of the total articles). (3) By exploring the co-occurrence and links strengths of keywords "COVID-19" (1075; 1092), "air pollution" (286; 771), "SARS-COV-2" (252; 1986). (4) The lessons deduced from the COVID-19 pandemic provide defined measures to reduce air pollution globally. The outcomes of the present study also provide useful guidelines for future research programs and constitute a baseline for researchers in the domain of environmental and health sciences to estimate the potential impact of the COVID-19 pandemic on air pollution.

Variation and dispersal of PM10 and PM2.5 during COVID-19 lockdown over Kolkata metropolitan city, India investigated through HYSPLIT model

The higher concentration of PM10 and PM2.5 in the lower atmosphere is severely harmful for human health and it also makes visibility diminution along with weather and climate modifications. The main objective is to find out the spatiotemporal variation and dispersal of PM10 and PM2.5 along with COVID-19 infection in the dusty city Kolkata. The consecutive two years PM10 and PM2.5 data of different stations have been obtained from State Pollution Control Board, Govt. of West Bengal. Forward trajectory analysis has been done through HYSPLIT (Hybrid Single Particle Lagrangian Integrated Trajectory) model to find the path and direction of air particles. The result showed that the various meteorological or environmental factors (such as temperature, relative humidity, wind, wind speed, pressure and gusty wind) and geographical location regulate the spatiotemporal variation of PM10 and PM2.5. These factors like high temperature with relative humidity and strong wind influence to disperse the particulate matters from north to south direction from city to outside during summer in Kolkata metropolitan city. During summer (both pre and lockdown years), the height of particles is extended up to 1000 m owing to active atmospheric ventilation whereas in winter it is confined within 100 m. The HYSPLIT model clearly specified that the particles dispersed from south, south-west to north and north east direction due to strong wind. The constant magnification of PM10 and PM2.5 in the lower atmosphere leads to greater frequency of COVID-19 infections and deaths. In Kolkata, the one of the crucial reasons of high infection and deaths (COVID-19) is co-morbidity of people.

The effects of air pollution, meteorological parameters, and climate change on COVID-19 comorbidity and health disparities: A systematic review

Air pollutants, especially particulate matter, and other meteorological factors serve as important carriers of infectious microbes and play a critical role in the spread of disease. However, there remains uncertainty about the relationship among particulate matter, other air pollutants, meteorological conditions and climate change and the spread of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), hereafter referred to as COVID-19. A systematic review was conducted using PRISMA guidelines to identify the relationship between air quality, meteorological conditions and climate change, and COVID-19 risk and outcomes, host related factors, co-morbidities and disparities. Out of a total of 170,296 scientific publications screened, 63 studies were identified that focused on the relationship between air pollutants and COVID-19. Additionally, the contribution of host related-factors, co-morbidities, and health disparities was discussed. This review found a preponderance of evidence of a positive relationship between PM_2.5, other air pollutants, and meteorological conditions and climate change on COVID-19 risk and outcomes. The effects of PM_2.5, air pollutants, and meteorological conditions on COVID-19 mortalities were most commonly experienced by socially disadvantaged and vulnerable populations. Results however, were not entirely consistent, and varied by geographic region and study. Opportunities for using data to guide local response to COVID-19 are identified.

Changes in air quality during and after large-scale social restriction periods in Jakarta city, Indonesia

COVID-19 outbreak has constrained human activities in Jakarta, Indonesia during the large-scale social restriction (LSSR) period. The objective of this study was to evaluate the changes in the spatial variation of air pollutants over Jakarta during and after the LSSR periods. This study used satellite retrievals such as OMI, AIRS, and MERRA-2 satellite data to assess spatial variations of NO₂, CO, O₃, SO₂, and PM2.5 from May to June 2020 (during the LSSR period) and from July to August 2020 (after the LSSR period) over Jakarta. The satellite images were processed using GIS software to increase the clarity of the images. The relationship between air pollutants and meteorological data was analyzed using Pearson correlation. The results showed the levels of NO₂, PM2.5, O₃, and CO increased by 59.4%, 21.2%, 16.2%, and 1.0%, respectively, while SO₂ decreased by 19.1% after the LSSR period. The temperature value was inversely correlated with PM2.5, NO₂, and SO₂ concentrations. Furthermore, the backward trajectory analysis revealed that air pollutants from outland areas such as the east and southeast carried more particulate matter and gases pollutants, which contributed to the air pollution during and after the LSSR periods. As a whole, the COVID-19 outbreak had bad impacts on human health, but the increase in air pollutants levels after loosening the LSSR policy could also lead to a higher risk of severe respiratory diseases. This study provides new insight into air pollutant distribution during and after LSSR periods and recommends an effective method of mitigating the air pollution issues in Jakarta.

Positive association between outdoor air pollution and the incidence and severity of COVID-19. A review of the recent scientific evidences

In June 2020, we published a review focused on assessing the influence of various air pollutants on the transmission of SARS-CoV-2, and the severity of COVID-19 in patients infected by the coronavirus. The results of most of those reviewed studies suggested that chronic exposure to certain air pollutants might lead to more severe and lethal forms of COVID-19, as well as delays/complications in the recovery of the patients. Since then, a notable number of studies on this topic have been published, including also various reviews. Given the importance of this issue, we have updated the information published since our previous review. Taking together the previous results and those of most investigations now reviewed, we have concluded that there is a significant association between chronic exposure to various outdoor air pollutants: PM2.5, PM10, O3, NO2, SO2 and CO, and the incidence/risk of COVID-19 cases, as well as the severity/mortality of the disease. Unfortunately, studies on the potential influence of other important air pollutants such as VOCs, dioxins and furans, or metals, are not available in the scientific literature. In relation to the influence of outdoor air pollutants on the transmission of SARS-CoV-2, although the scientific evidence is much more limited, some studies point to PM2.5 and PM10 as potential airborne transmitters of the virus. Anyhow, it is clear that environmental air pollution plays an important negative role in COVID-19, increasing its incidence and mortality.

PM2.5 concentration prediction during COVID-19 lockdown over Kolkata metropolitan city, India using MLR and ANN models

Kolkata is the third densely populated city of India and Kolkata stands in the World's 25 most polluted cities along with 10 worse polluted cities in India. The relevant study claims that due to the imposition of lockdown during COVID-19 pandemic, the atmospheric pollution level has been significantly reduced over the metropolitan city Kolkata like other cities of the world. The main objective of this study is to predict the concentration of PM_2.5 using multiple linear regression (MLR) and artificial neural network (ANN) models and similarly, to compare the accuracy level of two models. The concentration of PM_2.5 data has been obtained from state pollution control board, Govt. of West Bengal and daily meteorological data have been collected from the world weather website. The results show that non-linear artificial neural network model is more rational compared with multiple linear regression model due to its high precision and accuracy level (in respect to RMSE, MAE and R²). In this research artificial neural network (ANN) model exhibited higher accuracy during the training and testing phases (root mean square error (RMSE), mean absolute error (MAE) and R² indicate 3.74, 1.14 and 0.91 respectively in training phase and 2.55, 4.32 and 0.69 in testing phase respectively). This model (ANN)) can be applied to predict the concentration of PM_2.5 during the execution of urban air quality management plan.

Climate change, environment pollution, COVID-19 pandemic and mental health

Converging data would indicate the existence of possible relationships between climate change, environmental pollution and epidemics/pandemics, such as the current one due to SARS-CoV-2 virus. Each of these phenomena has been supposed to provoke detrimental effects on mental health. Therefore, the purpose of this paper was to review the available scientific literature on these variables in order to suggest and comment on their eventual synergistic effects on mental health. The available literature report that climate change, air pollution and COVID-19 pandemic might influence mental health, with disturbances ranging from mild negative emotional responses to full-blown psychiatric conditions, specifically, anxiety and depression, stress/trauma-related disorders, and substance abuse. The most vulnerable groups include elderly, children, women, people with pre-existing health problems especially mental illnesses, subjects taking some types of medication including psychotropic drugs, individuals with low socio-economic status, and immigrants. It is evident that COVID-19 pandemic uncovers all the fragility and weakness of our ecosystem, and inability to protect ourselves from pollutants. Again, it underlines our faults and neglect towards disasters deriving from climate change or pollution, or the consequences of human activities irrespective of natural habitats and constantly increasing the probability of spillover of viruses from animals to humans. In conclusion, the psychological/psychiatric consequences of COVID-19 pandemic, that currently seem unavoidable, represent a sharp cue of our misconception and indifference towards the links between our behaviour and their influence on the "health" of our planet and of ourselves. It is time to move towards a deeper understanding of these relationships, not only for our survival, but for the maintenance of that balance among man, animals and environment at the basis of life in earth, otherwise there will be no future.

Investigating connections between COVID-19 pandemic, air pollution and community interventions for Pakistan employing geoinformation technologies

Several major cities that witnessed heavy air pollution by particulate matter (PM2.5) concentration and nitrogen dioxide (NO2) have contributed to high rate of infection and severity of the coronavirus disease (COVID-19) pandemic. Owing to the negative impact of COVID-19 on health and economy, it is imperative to predict the pandemic trend of the COVID-19 outbreak. Pakistan is one of the mostly affected countries by recent COVID-19 pandemic in terms of COVID-cases and economic crises. Like other several Asian countries to combat the virus impacts, Pakistan implemented non-pharmacological interventions (NPI), such as national lockdowns. The current study investigates the effect of major interventions across three out of four provinces of Pakistan for the period from the start of the COVID-19 in March 22, 2020 until June 30, 2020, when lockdowns were started to be eased. High-resolution data on NO2 was recorded from Sentinel-5's Precursor spacecraft with TROPOspheric Monitoring Instrument (Sentinel-5P TROPOMI). Similarly, PM2.5 data were collected from sampling sties to investigate possible correlation among these pollutants and COVID-19. In addition, growth and susceptible-infected-recovered (SIR) models utilizing time-series data of COVID-19 from February 26 to December 31, 2020, with- and without NPI that encompass the predicted number of infected cases, peak time, impact on the healthcare system and mortality in Pakistan. Maximum mean PM2.5 concentration of 108 μgm-3 was recorded for Lahore with the range from 51 to 215 μgm-3, during strict lockdown (L), condition. This is three times higher than Pak-EPA and US-EPA and four times for WHO guidelines, followed by Peshawar (97.2 and 58 ± 130), Islamabad (83 and 158 ± 58), and Karachi (78 and 50 ± 140). The majority of sampling sites in Lahore showed NO2 levels higher than 8.75E-5 (mol/m2) in 2020 compared to 2019 during "L" period. The susceptible-infected-recovered (SIR) model depicted a strong correlation (r) between the predicted and reported cases for Punjab (r = 0.79), Sindh (r = 0.91), Khyber Pakhtunkhwa (KPK) (r = 94) and Islamabad (r = 0.85). Findings showed that major NPI and lockdowns especially have had a large effect on minimizing transmission. Continued community intervention should be undertaken to keep transmission of SARS-CoV-2 under control in cities where higher incidence of COVID-19 cases until the vaccine is available. This study provides a methodological framework that if adopted can assist epidemiologist and policy makers to be well-prepared in advance in cities where PM2.5 concentration and NO2 levels are already high in order to minimize the potential risk of further spread of COVID-19 cases.