ABSTRACT
Introduction: Air pollutant exposure constitutes a serious risk factor for the emergence or aggravation of (existing) pulmonary disease. Aim(s): In this study, we wanted to investigate if recent and chronic exposures to ambient air pollution (AP) is associated with COVID-19 disease severity in a cohort of hospitalized COVID-19 patients. Method(s): 283 COVID-19 patients were recruited at the time of admission to hospital. Several clinical parameters and outcomes were collected from medical records, including the duration of stay, the early-warning score (EWS), oxygen saturation in blood at admission, admission to the intensive care unit (ICU), and clinical improvement at 30 and at 90 days after the day of admission. Daily exposure levels for PM , PM , NO and black carbon (BC) were modeled using a high-resolution spatiotemporal model. Based on daily exposure levels, average exposures 2 days and 1 week before admission and chronic exposure. Result(s): We observed a significant association between the duration of stay and exposure to PM , PM and NO (recent and chronic exposure). For BC, only chronic exposure (CP) was significantly associated with the duration of stay. On average, the duration of stay increased by 1 to 6 days for an inter-quartile range increase in average exposure to AP in the week before admission. CP was associated with 2 to 3 days increased duration of stay. An increase in PM2.5 and PM10 exposure 1 week before admission was associated with higher EWS. Conclusion(s): Exposure to AP was associated with duration of stay and EWS at the time of admission, which implies a potential link between AP exposure and COVID-19 disease severity, and a significant influence of AP exposure on the pressure of care systems.
ABSTRACT
Background: Previous data has suggested that shorter telomere length (TL) is associated with higher risk of adverse COVID-19 outcomes, independent of several major risk factors for COVID-19 including age. Aim(s): We aimed at further exploring the relationship between TL and COVID-19 outcome in hospitalized patients. Method(s): 257 patients with proven COVID-19 infection with or without respiratory symptoms were included. Leucocyte TL was determined using qPCR (quantitative polymerase chain reaction) in leukocytes collected at the time of hospitalization. Clinical assessment related to disease severity and progress were collected from medical records, hospitalization duration, ventilation, early warning score (EWS) and clinical improvement using the WHO-scores. Result(s): Patients with longer TL at admission had less severe outcomes and a more rapid health improvement. the odds ratios for a 1-SD increment in TL associated with hospitalization duration were 0.58 (95%Cl: 0.46-0.73: P<0.0001) unadjusted and 0.77 (95%Cl:0.59-0.99: P=0.044) adjusted for age, sex, BMI, smoking, ethnicity and comorbidities. In men, a 1-SD increment in TL was associated with lower odds (adjusted OR=0.48 95%Cl 0.30-0.77 P=0.0015) to be on ventilation, and with a lower EWS at admission (adjusted s=0.13 95%Cl:0.23-0.02 P=0.024). Finally, a 1-SD increment in TL in men was associated with a stronger decline in disease severity (based on WHOscores) after 30 days post-hospitalization(adjusted s=0.29 95%Cl:0.56-0.03 P=0.029). Conclusion(s): Biological ageing forms an additional risk factor in COVID-19 infected patients to have more disease severity and progression. TL, especially in men, may form a biological basis in these observations.