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Identifying environmental risk factors for post-acute sequelae of SARS-CoV-2 infection: An EHR-based cohort study from the recover program.
Zhang, Yongkang; Hu, Hui; Fokaidis, Vasilios; V, Colby Lewis; Xu, Jie; Zang, Chengxi; Xu, Zhenxing; Wang, Fei; Koropsak, Michael; Bian, Jiang; Hall, Jaclyn; Rothman, Russell L; Shenkman, Elizabeth A; Wei, Wei-Qi; Weiner, Mark G; Carton, Thomas W; Kaushal, Rainu.
  • Zhang Y; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States.
  • Hu H; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
  • Fokaidis V; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States.
  • V CL; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States.
  • Xu J; Department of Health Outcomes Biomedical Informatics, University of Florida, Gainesville, FL, United States.
  • Zang C; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States.
  • Xu Z; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States.
  • Wang F; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States.
  • Koropsak M; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States.
  • Bian J; Department of Health Outcomes Biomedical Informatics, University of Florida, Gainesville, FL, United States.
  • Hall J; Department of Health Outcomes Biomedical Informatics, University of Florida, Gainesville, FL, United States.
  • Rothman RL; Institute of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, United States.
  • Shenkman EA; Department of Health Outcomes Biomedical Informatics, University of Florida, Gainesville, FL, United States.
  • Wei WQ; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States.
  • Weiner MG; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States.
  • Carton TW; Louisiana Public Health Institute, New Orleans, LA, United States.
  • Kaushal R; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States.
Environ Adv ; 11: 100352, 2023 Apr.
Article in English | MEDLINE | ID: covidwho-2237542
ABSTRACT
Post-acute sequelae of SARS-CoV-2 infection (PASC) affects a wide range of organ systems among a large proportion of patients with SARS-CoV-2 infection. Although studies have identified a broad set of patient-level risk factors for PASC, little is known about the association between "exposome"-the totality of environmental exposures and the risk of PASC. Using electronic health data of patients with COVID-19 from two large clinical research networks in New York City and Florida, we identified environmental risk factors for 23 PASC symptoms and conditions from nearly 200 exposome factors. The three domains of exposome include natural environment, built environment, and social environment. We conducted a two-phase environment-wide association study. In Phase 1, we ran a mixed effects logistic regression with 5-digit ZIP Code tabulation area (ZCTA5) random intercepts for each PASC outcome and each exposome factor, adjusting for a comprehensive set of patient-level confounders. In Phase 2, we ran a mixed effects logistic regression for each PASC outcome including all significant (false positive discovery adjusted p-value < 0.05) exposome characteristics identified from Phase I and adjusting for confounders. We identified air toxicants (e.g., methyl methacrylate), particulate matter (PM2.5) compositions (e.g., ammonium), neighborhood deprivation, and built environment (e.g., food access) that were associated with increased risk of PASC conditions related to nervous, blood, circulatory, endocrine, and other organ systems. Specific environmental risk factors for each PASC condition and symptom were different across the New York City area and Florida. Future research is warranted to extend the analyses to other regions and examine more granular exposome characteristics to inform public health efforts to help patients recover from SARS-CoV-2 infection.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Language: English Journal: Environ Adv Year: 2023 Document Type: Article Affiliation country: J.envadv.2023.100352

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Language: English Journal: Environ Adv Year: 2023 Document Type: Article Affiliation country: J.envadv.2023.100352