A review through researchers at Imperial College London provides explicit evidence of an agreement between average exposure to nitrogen dioxide (NO2) in the 2014-2018 era and COVID-19 mortality, while the role of atmospheric waste (PM2.5) remains much more controversial. . Lately, the document is available on the medRxiv prepress server.
Amid the immediate escalation of the spread of coronavirus disease (COVID-19) and deaths around the world, and despite all precautions, questions arise about unrecognized threat points in the past that would possibly influence mortality rates.
As a result, recent studies recommend a forward-looking link between long-term exposure to air pollutants and COVID-19 mortality. However, due to its eco-friendly design based on giant area units, they do not take into account strong models of localized air pollutants, which can lead prospectively to an insufficient confusion adjustment.
As a result, a study organization of the MRC Centre for Environment and Health and the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom, pointed to the effect of long-term exposure to NO2 and PM2.5. Deaths by COVID-19 until 30 June 2020, in England with the use of a higher geographical resolution.
“We hypothesize that long-term exposure to these compounds worsens the diagnosis of COVID-19 patients, as exposure to contaminants can suppress early immune responses to infection, leading to an upcoming buildup of inflammation and, as possibly, the onset of pre-existing conditions,” the study authors say.
This study effort is the first national review in England to compare the effect of long-term exposure to NO2 and PM2.5 in the 2014-2018 era on COVID-19 mortality in the decreasing super-output zone.
The authors included 38,573 deaths due to COVID-19 in the reduction layer of overproduction 8 in England (n -32,844 small regions). The Lower Layer Overproduction Area (LSOA) is a geospatial statistical unit used in England and Wales to facilitate the reporting of statistics on small s. In addition, they recovered the average concentration values of NO2 and PM2.5 during the 2014-2018 era of the weather mapping model of pollutants.
In order to integrate data at various levels, Bayesian hierarchical models have been used to quantify the effect of air pollution, while adjusting a series of spatial autocorrection and confusion.
Finally, in a rigorous post hoc analysis, the researchers tested whether evidence of an effect of NO2 on COVID-19 mortality can simply be attributed to pre-existing conditions. In particular, diabetes, high blood pressure and chronic obstructive pulmonary disease (COPD) were decided on the availability of recent medical knowledge and literature.
The resulting style indicates that for the accumulation of 1 g/m3 in long-term exposure to NO2 and PM2.5, COVID-19 mortality rates increase to 0.5% and 1.4% respectively, after spatial confusion adjustment and self-freezing effect. . Training
However, it should be noted that this evidence is less strong for NO2, while for PM2.5, there is greater uncertainty. This corresponds to a later probability of a positive effect of 0.93 and 0.78, respectively.
In addition, the relative spatial threat showed strong spatial trends, fundamentally equal to other pollutants, potentially capturing the spread of the disease in the first wave of the COVID-19 pandemic.
“Compared to previous studies, our effects are the smallest in magnitude, probably due to the maximum geographic accuracy that allows for more accurate confusion and adjustment of spatial autocorrect,” the authors examine in their medRxiv paper.
In addition, lack of strength and knowledge of individual exposure may also have contributed to weak evidence of an effect. Since for NO2, the authors discovered a later probability of a fatal outcome, they argued that a prospective explanation may also simply be the mediating effect of the pre-existing conditions mentioned above.
The research also captured a strong spatial self-correction. Such a trend may simply reflect a residual variation of a covariate adjustment with all deficient probability (including disease spread), spatial variation under pre-existing conditions, other unspecified spatial confusion factors, or a mixture of these.
In conclusion, this review provided evidence that there is a link between average exposure to NO2 and mortality in COVID-19; however, additional studies will surely clarify the precise role of PM2.5.
medRxiv publishes initial clinical reports that are not peer-reviewed and are therefore not considered conclusive, clinical practices/health-related behaviors, nor are they treated as established information.
Written by
Dr. Tomislav Me-trovio is a physician (MD) with a physicist. in biomedical and fitness sciences, specialist in the area of clinical microbiology and assistant professor at the youngest University of Croatia – University North. In addition to his interest in clinical activities and conferences, his immense hobby in medical writing and clinical communication dates back to his student days. He likes to contribute to the community. In his spare time, Tomislav is a filmmaker and a wonderful traveler.
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