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Effects of Environmental Factors on Severity and Mortality of COVID-19.

ABSTRACT: Background: Most respiratory viruses show pronounced seasonality, but for SARS-CoV-2, this still needs to be documented. Methods: We examined the disease progression of COVID-19 in 6,914 patients admitted to hospitals in Europe and China. In addition, we evaluated progress of disease symptoms in 37,187 individuals reporting symptoms into the COVID Symptom Study application. Findings: Meta-analysis of the mortality risk in seven European hospitals estimated odds ratios per 1-day increase in the admission date to be 0.981 (0.973-0.988, p < 0.001) and per increase in ambient temperature of 1°C to be 0.854 (0.773-0.944, p = 0.007). Statistically significant decreases of comparable magnitude in median hospital stay, probability of transfer to the intensive care unit, and need for mechanical ventilation were also observed in most, but not all hospitals. The analysis of individually reported symptoms of 37,187 individuals in the UK also showed the decrease in symptom duration and disease severity with time. Interpretation: Severity of COVID-19 in Europe decreased significantly between March and May and the seasonality of COVID-19 is the most likely explanation.

SUBMITTER: Kifer D

PROVIDER: S-EPMC7855590 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Effects of Environmental Factors on Severity and Mortality of COVID-19.

Kifer Domagoj D Bugada Dario D Villar-Garcia Judit J Gudelj Ivan I Menni Cristina C Sudre Carole C Vučković Frano F Ugrina Ivo I Lorini Luca F LF Posso Margarita M Bettinelli Silvia S Ughi Nicola N Maloberti Alessandro A Epis Oscar O Giannattasio Cristina C Rossetti Claudio C Kalogjera Livije L Peršec Jasminka J Ollivere Luke L Ollivere Benjamin J BJ Yan Huadong H Cai Ting T Aithal Guruprasad P GP Steves Claire J CJ Kantele Anu A Kajova Mikael M Vapalahti Olli O Sajantila Antti A Wojtowicz Rafal R Wierzba Waldemar W Krol Zbigniew Z Zaczynski Artur A Zycinska Katarina K Postula Marek M Lukšić Ivica I Čivljak Rok R Markotić Alemka A Brachmann Johannes J Markl Andreas A Mahnkopf Christian C Murray Benjamin B Ourselin Sebastien S Valdes Ana M AM Horcajada Juan P JP Castells Xavier X Pascual Julio J Allegri Massimo M Primorac Dragan D Spector Tim D TD Barrios Clara C Lauc Gordan G

Frontiers in medicine 20210120

Background: Most respiratory viruses show pronounced seasonality, but for SARS-CoV-2, this still needs to be documented. Methods: We examined the disease progression of COVID-19 in 6,914 patients admitted to hospitals in Europe and China. In addition, we evaluated progress of disease symptoms in 37,187 individuals reporting symptoms into the COVID Symptom Study application. Findings: Meta-analysis of the mortality risk in seven European hospitals estimated odds ratios per 1- ...[more]

PMID: 33553204

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Project description:BackgroundIn December 2019, a novel coronavirus disease (COVID-19) broke out in Wuhan, China; however, the factors affecting the mortality of COVID-19 remain unclear.MethodsThirty-two days of data (the growth rate/mortality of COVID-19 cases) that were shared by Chinese National Health Commission and Chinese Weather Net were collected by two authors independently. Student's t-test or Mann-Whitney U test was used to test the difference in the mortality of confirmed/severe cases before and after the use of "Fangcang, Huoshenshan, and Leishenshan" makeshift hospitals (MSHs). We also studied whether the above outcomes of COVID-19 cases were related to air temperature (AT), relative humidity (RH), or air quality index (AQI) by performing Pearson's analysis or Spearman's analysis.ResultsEight days after the use of MSHs, the mortality of confirmed cases was significantly decreased both in Wuhan (t = 4.5, P < 0.001) and Hubei (U = 0, P < 0.001), (t and U are the test statistic used to test the significance of the difference). In contrast, the mortality of confirmed cases remained unchanged in non-Hubei regions (U = 76, P = 0.106). While on day 12 and day 16 after the use of MSHs, the reduce in mortality was still significant both in Wuhan and Hubei; but in non-Hubei regions, the reduce also became significant this time (U = 123, P = 0.036; U = 171, P = 0.015, respectively). Mortality of confirmed cases was found to be negatively correlated with AT both in Wuhan (r = - 0.441, P = 0.012) and Hubei (r = - 0.440, P = 0.012). Also, both the growth rate and the mortality of COVID-19 cases were found to be significantly correlated with AQI in Wuhan and Hubei. However, no significant correlation between RH and the growth rate/mortality of COVID-19 cases was found in our study.ConclusionsOur findings indicated that both the use of MSHs, the rise of AT, and the improvement of air quality were beneficial to the survival of COVID-19 patients.

Project description:Background and purposeThe objective of our systematic review is to identify prognostic factors that may be used in decision-making related to the care of patients infected with COVID-19.Data sourcesWe conducted highly sensitive searches in PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL) and Embase. The searches covered the period from the inception date of each database until April 28, 2020. No study design, publication status or language restriction were applied.Study selection and data extractionWe included studies that assessed patients with confirmed or suspected SARS-CoV-2 infectious disease and examined one or more prognostic factors for mortality or disease severity. Reviewers working in pairs independently screened studies for eligibility, extracted data and assessed the risk of bias. We performed meta-analyses and used GRADE to assess the certainty of the evidence for each prognostic factor and outcome.ResultsWe included 207 studies and found high or moderate certainty that the following 49 variables provide valuable prognostic information on mortality and/or severe disease in patients with COVID-19 infectious disease: Demographic factors (age, male sex, smoking), patient history factors (comorbidities, cerebrovascular disease, chronic obstructive pulmonary disease, chronic kidney disease, cardiovascular disease, cardiac arrhythmia, arterial hypertension, diabetes, dementia, cancer and dyslipidemia), physical examination factors (respiratory failure, low blood pressure, hypoxemia, tachycardia, dyspnea, anorexia, tachypnea, haemoptysis, abdominal pain, fatigue, fever and myalgia or arthralgia), laboratory factors (high blood procalcitonin, myocardial injury markers, high blood White Blood Cell count (WBC), high blood lactate, low blood platelet count, plasma creatinine increase, high blood D-dimer, high blood lactate dehydrogenase (LDH), high blood C-reactive protein (CRP), decrease in lymphocyte count, high blood aspartate aminotransferase (AST), decrease in blood albumin, high blood interleukin-6 (IL-6), high blood neutrophil count, high blood B-type natriuretic peptide (BNP), high blood urea nitrogen (BUN), high blood creatine kinase (CK), high blood bilirubin and high erythrocyte sedimentation rate (ESR)), radiological factors (consolidative infiltrate and pleural effusion) and high SOFA score (sequential organ failure assessment score).ConclusionIdentified prognostic factors can help clinicians and policy makers in tailoring management strategies for patients with COVID-19 infectious disease while researchers can utilise our findings to develop multivariable prognostic models that could eventually facilitate decision-making and improve patient important outcomes.Systematic review registrationProspero registration number: CRD42020178802. Protocol available at: https://www.medrxiv.org/content/10.1101/2020.04.08.20056598v1.

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Effects of Environmental Factors on Severity and Mortality of COVID-19.

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Effects of Environmental Factors on Severity and Mortality of COVID-19.

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