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1.
Sci Total Environ ; 795: 148764, 2021 Nov 15.
Article in English | MEDLINE | ID: covidwho-1294225

ABSTRACT

Sandstorms are a natural metrological phenomenon, frequently occurring in many arid and semi-arid regions of the world. The sandstorm dust contains environmental pollutants, microorganisms including bacteria, fungi, and viruses. These events are the primary sources of air pollution and its long-distance transport. Thus, sandstorms are becoming a greater concern during the COVID-19 pandemic. Therefore, this novel study aimed to investigate the effect of a sandstorm on "environmental pollutants particulate matter (PM2.5), carbon monoxide (CO), ozone (O3), nitrogen dioxide (NO2), and day-to-day new cases and deaths due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection" in Riyadh, Saudi Arabia. On March 12, 2021, a sandstorm occurred in the Riyadh region, the capital city of Saudi Arabia. The data on PM 2.5, CO, NO2, and O3 were recorded three weeks before and three weeks after the onset of the sandstorm, from February 20, 2021, to March 12, 2021, and from March 13 to April 2, 2021. The daily PM2.5, CO, NO2, and O3 levels were documented from the metrological websites, and Air Quality Index-AQI, COVID-19 daily cases, and deaths were obtained from Saudi Arabia's official coronavirus website. After sandstorm, the air pollutants, CO level increased by 84.25%; PM2.5: 76.71%; O3: 40.41%; NO2: 12.03%; and SARS-CoV-2 cases increased by 33.87%. However, the number of deaths decreased by 22.39%. The sandstorm event significantly increased the air pollutants, PM2.5, CO, and O3, which were temporally associated with increased SARS-COV-2 cases. However, no significant difference was noticed in NO2 and the number of deaths after the sandstorm. The findings have an important message to health authorities to timely provide information to the public about the sandstorm and its associated health problems, including SARS-CoV-2 cases and deaths.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Environmental Pollutants , Ozone , Air Pollutants/adverse effects , Air Pollutants/analysis , Air Pollution/adverse effects , Air Pollution/analysis , Carbon Monoxide , Humans , Nitric Oxide , Nitrogen Dioxide/analysis , Ozone/adverse effects , Ozone/analysis , Pandemics , Particulate Matter/adverse effects , Particulate Matter/analysis , SARS-CoV-2
2.
Int Immunopharmacol ; 98: 107874, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1267706

ABSTRACT

BACKGROUND: Following positive experience on the use of blood ozonation in SARS-CoV-2, the CORMOR randomized trial was designed to evaluate the adjuvant role of oxygen/ozone therapy in mild to moderate SARS-CoV-2 pneumonia. METHODS: The trial (ClinicalTrial.gov NCT04388514) was conducted in four different Italian centers (April-October 2020). Patients were treated according to best available standard of care (SoC) therapy, with or without O3-autohemotherapy (O3-AHT). RESULTS: A total of 92 patients were enrolled: SoC + O3-AHT (48 patients) were compared to the SoC treatment (44 patients). The two groups differed in steroids therapy administration (72.7% in SoC arm vs. 50.0% in O3-AHT arm; p = 0.044). Steroid therapy was routinely started when it was subsequently deemed as effective for the treatment of COVID-19 disease. No significant differences in mortality rates, length of hospital stay, mechanical ventilation requirement and ICU admission were observed. Clinical improvement in patients with pneumonia was assessed according to a specifically designed score (decrease in SIMEU class, improvement in radiology imaging, improvement in PaO2/FiO2, reduction in LDH and requirement of oxygen therapy ≤ 5 days). Score assessment was performed on day-3 (T3) and day-7 (TEnd) of O3-AHT treatment. A significant increase in the score was reported at TEnd, in the O3-AHT treatment arm (0 [0-1] in the SoC arm vs. 2 [1-3] the O3-AHT arm; p = 0.018). No adverse events related O3-AHT treatment was observed. CONCLUSION: In mild-to-moderate pneumonia due to SARS-CoV-2, adjuvant oxygen/ozone therapy did not show any effect on mortality, or mechanical intubation but show a clinical improvement a day 7 from randomization in a composite clinical endpoint. Larger Randomized prospective studies alone or in combination with steroids are needed to confirm our results.


Subject(s)
COVID-19/therapy , Lung/physiopathology , Ozone/administration & dosage , Respiratory Insufficiency/therapy , Aged , COVID-19/blood , COVID-19/mortality , COVID-19/physiopathology , Female , Hospital Mortality , Humans , Italy , Length of Stay , Lung/virology , Male , Middle Aged , Ozone/adverse effects , Ozone/blood , Prospective Studies , Respiration, Artificial , Respiratory Insufficiency/blood , Respiratory Insufficiency/mortality , Respiratory Insufficiency/physiopathology , Severity of Illness Index , Time Factors , Treatment Outcome
3.
Environ Health ; 20(1): 41, 2021 04 10.
Article in English | MEDLINE | ID: covidwho-1175326

ABSTRACT

BACKGROUND: Air pollution is one of the world's leading mortality risk factors contributing to seven million deaths annually. COVID-19 pandemic has claimed about one million deaths in less than a year. However, it is unclear whether exposure to acute and chronic air pollution influences the COVID-19 epidemiologic curve. METHODS: We searched for relevant studies listed in six electronic databases between December 2019 and September 2020. We applied no language or publication status limits. Studies presented as original articles, studies that assessed risk, incidence, prevalence, or lethality of COVID-19 in relation with exposure to either short-term or long-term exposure to ambient air pollution were included. All patients regardless of age, sex and location diagnosed as having COVID-19 of any severity were taken into consideration. We synthesised results using harvest plots based on effect direction. RESULTS: Included studies were cross-sectional (n = 10), retrospective cohorts (n = 9), ecological (n = 6 of which two were time-series) and hypothesis (n = 1). Of these studies, 52 and 48% assessed the effect of short-term and long-term pollutant exposure, respectively and one evaluated both. Pollutants mostly studied were PM2.5 (64%), NO2 (50%), PM10 (43%) and O3 (29%) for acute effects and PM2.5 (85%), NO2 (39%) and O3 (23%) then PM10 (15%) for chronic effects. Most assessed COVID-19 outcomes were incidence and mortality rate. Acutely, pollutants independently associated with COVID-19 incidence and mortality were first PM2.5 then PM10, NO2 and O3 (only for incident cases). Chronically, similar relationships were found for PM2.5 and NO2. High overall risk of bias judgments (86 and 39% in short-term and long-term exposure studies, respectively) was predominantly due to a failure to adjust aggregated data for important confounders, and to a lesser extent because of a lack of comparative analysis. CONCLUSION: The body of evidence indicates that both acute and chronic exposure to air pollution can affect COVID-19 epidemiology. The evidence is unclear for acute exposure due to a higher level of bias in existing studies as compared to moderate evidence with chronic exposure. Public health interventions that help minimize anthropogenic pollutant source and socio-economic injustice/disparities may reduce the planetary threat posed by both COVID-19 and air pollution pandemics.


Subject(s)
Air Pollutants/adverse effects , Air Pollution/adverse effects , COVID-19/epidemiology , COVID-19/mortality , Environmental Exposure/adverse effects , Humans , Incidence , Nitrogen Dioxide/adverse effects , Ozone/adverse effects , Particulate Matter/adverse effects , Prevalence , Prognosis , Sulfur Dioxide/adverse effects
4.
Eur J Public Health ; 31(1): 7-12, 2021 02 01.
Article in English | MEDLINE | ID: covidwho-1066310

ABSTRACT

BACKGROUND: Italy was the second country in the world, after China, to be hit by SARS-CoV-2 pandemic. Italy's experience teaches that steps to limit people's movement by imposing 'red zones' need to be put in place early by carefully identifying the cities to be included within these areas of quarantine. The assessment of the relationship between the distance from an established outbreak of SARS-CoV-2 infection with transmission-linked cases and mortality observed in other sites could provide useful information to identify the optimal radius of red zones. METHODS: We investigated the relationship between SARS-CoV-2 cases and the distance of each Italian province from the first outbreak of SARS-CoV-2 epidemic in Italy (the city of Lodi placed in the Lombardia region). In 38 provinces of Lombardia and neighboring regions, we performed a breakpoint analysis to identify the radius of the red zone around Lodi minimizing epidemic spread and mortality in neighboring cities. RESULTS: In all Italian provinces, a non-linear relationship was found between SARS-CoV-2 cases and distance from Lodi. In an analysis including the provinces of Lombardia and neighboring regions, SARS-CoV-2 cases and mortality increased when the distance from Lodi reduced below 92 and 140 km, respectively, and such relationships were amplified by ozone (O3) pollution. CONCLUSIONS: The breakpoint analysis identifies the radius around the outbreak of Lodi minimizing the public health consequences of SARS-CoV-2 in neighboring cities. Such an approach can be useful to identify the red zones in future epidemics due to highly infective pathogens similar to SARS-CoV-2.


Subject(s)
COVID-19/mortality , Disease Outbreaks/statistics & numerical data , Mortality/trends , Ozone/adverse effects , Pandemics , SARS-CoV-2 , Adult , Aged , Aged, 80 and over , Basic Reproduction Number , COVID-19/epidemiology , Female , Geography, Medical , Humans , Italy/epidemiology , Male , Public Health , Public Health Surveillance
5.
Pediatr Allergy Immunol ; 31 Suppl 26: 26-28, 2020 11.
Article in English | MEDLINE | ID: covidwho-944772

ABSTRACT

Respiratory allergies are known to affect people all over the world. Environmental factors related to pollution play a significant etiopathogenic role in this regard. Polluting sources are industrial activities and urban traffic, capable of generating various types of pollutants that trigger inflammatory, direct, and indirect damage to tissues, promoting allergic symptoms, even serious ones, and interfering with the pharmacologic response. They are also able to modify pollen, promoting allergic sensitization. Pollution could have played a significant predisposing role in the ongoing morbidity and mortality of SARS-CoV-2.


Subject(s)
Air Pollution/adverse effects , COVID-19/epidemiology , Respiratory Hypersensitivity/etiology , SARS-CoV-2 , Child , Humans , Nitrogen Dioxide/adverse effects , Ozone/adverse effects , Particulate Matter/adverse effects
6.
J Med Virol ; 93(4): 2210-2220, 2021 04.
Article in English | MEDLINE | ID: covidwho-893240

ABSTRACT

The evaluation of new therapeutic resources against coronavirus disease 2019 (COVID-19) represents a priority in clinical research considering the minimal options currently available. To evaluate the adjuvant use of systemic oxygen-ozone administration in the early control of disease progression in patients with COVID-19 pneumonia. PROBIOZOVID is an ongoing, interventional, randomized, prospective, and double-arm trial enrolling patient with COVID-19 pneumonia. From a total of 85 patients screened, 28 were recruited. Patients were randomly divided into ozone-autohemotherapy group (14) and control group (14). The procedure consisted in a daily double-treatment with systemic Oxygen-ozone administration for 7 days. All patients were treated with ad interim best available therapy. The primary outcome was delta in the number of patients requiring orotracheal-intubation despite treatment. Secondary outcome was the difference of mortality between the two groups. Moreover, hematological parameters were compared before and after treatment. No differences in the characteristics between groups were observed at baseline. As a preliminary report we have observed that one patient for each group needed intubation and was transferred to ITU. No deaths were observed at 7-14 days of follow up. Thirty-day mortality was 8.3% for ozone group and 10% for controls. Ozone therapy did not significantly influence inflammation markers, hematology profile, and lymphocyte subpopulations of patients treated. Ozone therapy had an impact on the need for the ventilatory support, although did not reach statistical significance. Finally, no adverse events related to the use of ozone-autohemotherapy were reported. Preliminary results, although not showing statistically significant benefits of ozone on COVID-19, did not report any toxicity.


Subject(s)
COVID-19/drug therapy , Oxygen/administration & dosage , Ozone/administration & dosage , COVID-19/blood , COVID-19/virology , Female , Humans , Lymphocyte Subsets/drug effects , Male , Middle Aged , Oxygen/adverse effects , Ozone/adverse effects , Probiotics/administration & dosage , SARS-CoV-2/isolation & purification
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