The Effect of Ambient Environmental Conditions on COVID-19 Mortality: A Systematic Review.
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ABSTRACT:
SUBMITTER: Romero Starke K
PROVIDER: S-EPMC8296503 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The covid-19 pandemic era was characterized by heavy usage and disposal of medical face masks, now estimated at over 1.24 trillion. Few studies had attempted to demonstrate the release of microplastics from face masks using simulated conditions and application of mechanical forces, far different from the effects experienced by face masks dumped in the open environment, in landfills and dumpsites. In the current study, we monitored the release of microplastics, organic contaminants and toxic metals from medical face masks degraded under normal outdoor environmental conditions, over a period of 60 weeks. We showed that face mask's decomposition proceeded via sunlight (UV) - initiated oxidative degradation, leading to the replacement of methylene (CH2-) and alkyl (CH3-) groups in face mask's polypropylene backbone with hydroxyl and ketonic functional groups. Organic compounds released from decaying face masks into the surrounding soil included alkanes, alkenes, carboxylic acids/diesters and phthalate esters. Mean maximum concentration of phthalates in the soil ranged from 3.14 mg/kg (diethyl phthalate) to 11.68 mg/kg di(2-ethylhexyl) phthalate. Heavy metals, including Cu, Pb, Cd, As, Sn and Fe, were released into the soil, leading to contamination factors of 3.11, 2.84, 2.42, 2.26, 1.80 and 0.99, respectively. Together, the metals gave a pollution load index (PLI) of 2.102, indicating that they constitute moderate pollution of the soil surrounding the heap of face masks. This study provides a realistic insight into the fate and impacts of the enormous amounts of face masks, disposed or abandoned in soil environments during the covid-19 pandemic.
| S-EPMC9699709 | biostudies-literature
Project description:We conducted this systematic review to identify and appraise studies investigating the coronavirus disease 2019 (COVID-19) effect on ambient air pollution status worldwide. The review of studies was conducted using determined search terms via three major electronic databases (PubMed, Web of Science, and Scopus) according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach. A total of 26 full-text studies were included in our analysis. The lockdown measures related to COVID-19 pandemic caused significant decreases in the concentrations of PM2.5, NO2, PM10, SO2 and CO globally in the range of 2.9%-76.5%, 18.0%-96.0%, 6.0%-75.0%, 6.8%-49.0% and 6.2%-64.8%, respectively. However, O3 concentration increased in the range of 2.4%-252.3%. The highest decrease of PM2.5 was found in 16 states of Malaysia (76.5%), followed by Zaragoza (Spain) with 58.0% and Delhi (India) with 53.1%. The highest reduction of NO2 was found in Salé city (Morocco) with 96.0%, followed by Mumbai (India) with 75.0%, India with 70.0%, Valencia (Spain) with 69.0%, and São Paulo (Brazil) with 68.0%, respectively. The highest increase of O3 was recorded for Milan (Italy) with 252.3% and 169.9% during the first and third phases of lockdown measures, and for Kolkata (India) with 87% at the second phase of lockdown measures. Owing to the lockdown restrictions in the studied countries and cities, driving and public transit as a proxy of human mobilities and the factors affecting emission sources of ambient air pollution decreased in the ranges of 30-88% and 45-94%, respectively. There was a considerable variation in the reduction of ambient air pollutants in the countries and cities as the degree of lockdown measures had varied there. Our results illustrated that the COVID-19 pandemic had provided lessons and extra motivations for comprehensive implementing policies to reduce air pollution and its health effects in the future.
| S-EPMC9750834 | biostudies-literature
Project description:The effect of corticosteroid therapy is still controversial on prevention of mortality in coronavirus disease-2019 (COVID-19). The objective of this study is to investigate the effect of corticosteroids on mortality. This systematic review was performed as per preferred reporting items for systematic reviews and meta-analyses guidelines. A systematic search was performed at different databases namely Medline/PubMed, Cochrane and Google scholar on 10 February 2022. A pooled estimate for effect of corticosteroid therapy on mortality was calculated as outcome of study. Risk bias analysis and Newcastle Ottawa Scale were used to assess the quality of randomized control trial (RCT) and cohort studies, respectively. Cochran's Q test and the I2 statistic were conducted for heterogeneity and accordingly study model was applied. A total 43 studies were included, having sample size of 96,852 patients. Amongst them, 19,426 and 77,426 patients received corticosteroid therapy (intervention group) or standard treatment without corticosteroid (control group), respectively. Mortality observed in the intervention and control group was 14.2% (2749) and 7.1% (5459), respectively. The pooled estimate 2.173 (95% CI: 2.0690-2.2820) showed significantly increased mortality in intervention as compared to control. The pooled estimate of methyprednisolone 1.206 (95% CI: 1.0770-1.3500) showed significantly increased mortality while the pooled estimate of dexamethasone 1.040 (95% CI: 0.9459-1.1440) showed insignificantly increased mortality as compared to control. In conclusion, corticosteroid therapy produced a negative prognosis as depicted by increased mortality among COVID-19 patients. The possible reasons might be delay in virus clearance and secondary infections due to corticosteroids initiated at high dose in the early stage of infection.
| S-EPMC9538928 | biostudies-literature
Project description:Data supporting the use of Tocilizumab (TCZ) in COVID-19 are contrasting and inconclusive. This meta-analysis aimed to assess TCZ effectiveness in reducing the mortality rate in COVID-19 patients. PubMed, Scopus, Embase, Cochrane, WILEY, and ClinicalTrials.gov were searched to evaluate observational studies and RCTs. The outcome was the mortality rate. Forty observational studies and seven RCTs, involving 9640 and 5556 subjects treated with Standard Therapy (ST) + TCZ or ST alone, respectively, were included. In patients treated with ST+TCZ, a higher survival (Log odds ratio = -0.41; 95% CI: -0.68 -0.14; p < 0.001) was found. Subgroups analyses were performed to better identify the possible interference of some parameters in modifying the efficacy of TCZ therapy on COVID-19 mortality. Separating observational from RCTs, no statistically significant (p = 0.70) TCZ-related reduction of mortality regarding RCTs was found, while a significant reduction (Log odds ratio = -0.52; 95% CI: -0.82 -0.22, p < 0.001) was achieved regarding the observational studies. Stratifying for the use of Invasive Mechanic Ventilation (IMV), a higher survival was found in patients treated with TCZ in the No-IMV and IMV groups (both p < 0.001), but not in the No-IMV/IMV group. Meta-regression analyses were also performed. The meta-analysis of observational studies reveals that TCZ is associated with reducing the mortality rate in both severe and critically ill patients. Although the largest RCT, RECOVERY, is in line with this result, the meta-analysis of RCTs failed to found any difference between ST + TCZ and ST. It is crucial to personalize the therapy considering the patients' characteristics.
| S-EPMC8307114 | biostudies-literature
Project description:BackgroundAnakinra might improve the prognosis of patients with moderate to severe COVID-19 (ie, patients requiring oxygen supplementation but not yet receiving organ support). We aimed to assess the effect of anakinra treatment on mortality in patients admitted to hospital with COVID-19.MethodsFor this systematic review and individual patient-level meta-analysis, a systematic literature search was done on Dec 28, 2020, in Medline (PubMed), Cochrane, medRxiv, bioRxiv, and the ClinicalTrials.gov databases for randomised trials, comparative studies, and observational studies of patients admitted to hospital with COVID-19, comparing administration of anakinra with standard of care, or placebo, or both. The search was repeated on Jan 22, 2021. Individual patient-level data were requested from investigators and corresponding authors of eligible studies; if individual patient-level data were not available, published data were extracted from the original reports. The primary endpoint was mortality after 28 days and the secondary endpoint was safety (eg, the risk of secondary infections). This study is registered on PROSPERO (CRD42020221491).Findings209 articles were identified, of which 178 full-text articles fulfilled screening criteria and were assessed. Aggregate data on 1185 patients from nine studies were analysed, and individual patient-level data on 895 patients were provided from six of these studies. Eight studies were observational and one was a randomised controlled trial. Most studies used historical controls. In the individual patient-level meta-analysis, after adjusting for age, comorbidities, baseline ratio of the arterial partial oxygen pressure divided by the fraction of inspired oxygen (PaO2/FiO2), C-reactive protein (CRP) concentrations, and lymphopenia, mortality was significantly lower in patients treated with anakinra (38 [11%] of 342) than in those receiving standard of care with or without placebo (137 [25%] of 553; adjusted odds ratio [OR] 0·32 [95% CI 0·20-0·51]). The mortality benefit was similar across subgroups regardless of comorbidities (ie, diabetes), ferritin concentrations, or the baseline PaO2/FiO2. In a subgroup analysis, anakinra was more effective in lowering mortality in patients with CRP concentrations higher than 100 mg/L (OR 0·28 [95% CI 0·17-0·47]). Anakinra showed a significant survival benefit when given without dexamethasone (OR 0·23 [95% CI 0·12-0·43]), but not with dexamethasone co-administration (0·72 [95% CI 0·37-1·41]). Anakinra was not associated with a significantly increased risk of secondary infections when compared with standard of care (OR 1·35 [95% CI 0·59-3·10]).InterpretationAnakinra could be a safe, anti-inflammatory treatment option to reduce the mortality risk in patients admitted to hospital with moderate to severe COVID-19 pneumonia, especially in the presence of signs of hyperinflammation such as CRP concentrations higher than 100 mg/L.FundingSobi.
| S-EPMC8352496 | biostudies-literature
Project description:To determine the effect of COVID-19 convalescent plasma on mortality, we aggregated patient outcome data from 10 randomized clinical trials, 20 matched control studies, 2 dose-response studies, and 96 case reports or case series. Studies published between January 1, 2020, and January 16, 2021, were identified through a systematic search of online PubMed and MEDLINE databases. Random effects analyses of randomized clinical trials and matched control data demonstrated that patients with COVID-19 transfused with convalescent plasma exhibited a lower mortality rate compared with patients receiving standard treatments. Additional analyses showed that early transfusion (within 3 days of hospital admission) of higher titer plasma is associated with lower patient mortality. These data provide evidence favoring the efficacy of human convalescent plasma as a therapeutic agent in hospitalized patients with COVID-19.
| S-EPMC7888247 | biostudies-literature
Project description:IntroductionOur study aims at identifying and quantifying the relationship between the cold and heat exposure and the risk of cardiovascular mortality through a systematic review and meta-analysis.Material and methodsA systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Peer-reviewed studies about the temperature and cardiovascular mortality were retrieved in the MEDLINE, Web of Science, and Scopus databases from January 2000 up to the end of 2015. The pooled effect sizes of short-term effect were calculated for the heat exposure and cold exposure separately. Also, we assessed the dose-response relationship of temperature-cardiovascular mortality by a change in units of latitudes, longitude, lag days and annual mean temperature by meta-regression.ResultAfter screening the titles, abstracts and full texts, a total of 26 articles were included in the meta-analysis. The risk of cardiovascular mortality increased by 5% (RR, 1.055; 95% CI [1.050-1.060]) for the cold exposure and 1.3% (RR, 1.013; 95% CI [1.011-1.015]) for the heat exposure. The short-term effects of cold and heat exposure on the risk of cardiovascular mortality in males were 3.8% (RR, 1.038; 95% CI [1.034-1.043]) and 1.1%( RR, 1.011; 95% CI [1.009-1.013]) respectively. Moreover, the effects of cold and heat exposure on risk of cardiovascular mortality in females were 4.1% (RR, 1.041; 95% CI [1.037-1.045]) and 1.4% (RR, 1.014; 95% CI [1.011-1.017]) respectively. In the elderly, it was at an 8.1% increase and a 6% increase in the heat and cold exposure, respectively. The greatest risk of cardiovascular mortality in cold temperature was in the 14 lag days (RR, 1.09; 95% CI [1.07-1.010]) and in hot temperatures in the seven lag days (RR, 1.14; 95% CI [1.09-1.17]). The significant dose-response relationship of latitude and longitude in cold exposure with cardiovascular mortality was found. The results showed that the risk of cardiovascular mortality increased with each degree increased significantly in latitude and longitude in cold exposure (0.2%, 95% CI [0.006-0.035]) and (0.07%, 95% CI [0.0003-0.014]) respectively. The risk of cardiovascular mortality increased with each degree increase in latitude in heat exposure (0.07%, 95% CI [0.0008-0.124]).ConclusionOur findings indicate that the increase and decrease in ambient temperature had a relationship with the cardiovascular mortality. To prevent the temperature- related mortality, persons with cardiovascular disease and the elderly should be targeted. The review has been registered with PROSPERO (registration number CRD42016037673).
| S-EPMC5546177 | biostudies-literature
Project description:Background and aimsOlder people have higher rates of comorbidities and may experience more severe inflammatory responses; therefore, are at higher risk of death. Herein, we aimed to systematically review the mortality in coronavirus disease 2019 (COVID-19) patients and its predictors in this age group.MethodsWe searched PubMed, Web of Science, and Science Direct using relevant keywords. Retrieved records underwent a two-step screening process consisting of title/abstract and full-text screenings to identify the eligible studies.ResultsSummarizing findings of 35 studies demonstrated that older patients have higher mortality rates compared to the younger population. A review of articles revealed that increasing age, body mass index, a male gender, dementia, impairment or dependency in daily activities, presence of consolidations on chest X-ray, hypoxemic respiratory failure, and lower oxygen saturation at admission were risk factors for death. High d-dimer levels, 25-hydroxy vitamin D serum deficiencies, high C-reactive protein (≥5 mg/L) levels plus any other abnormalities of lymphocyte, higher blood urea nitrogen or lactate dehydrogenase, and higher platelet count were predictors of poor prognosis and mortality in the elderly. Studies have also shown that previous treatment with renin-angiotensin-aldosterone system inhibitors, pharmacological treatments of respiratory disorders, antibiotics, corticosteroids, vitamin K antagonist, antihistamines, azithromycin, Itolizumab (an anti-CD6 monoclonal antibody) in combination with other antivirals reduces COVID-19 worsening and mortality. Vaccination against seasonal influenza might also reduce COVID-19 mortality.ConclusionOverall, a critical consideration is necessary for the care and management of COVID-19 in the aged population considering the drastic contrasts in manifestation and prognosis compared to other age groups. Mortality from COVID-19 is independently associated with the patient's age. Elderly patients with COVID-19 are more vulnerable to poor outcomes. Thus, strict preventive measures, timely diagnosis, and aggressive therapeutic/nontherapeutic care are of great importance to reduce acute respiratory distress syndrome and severe complications in older people.
| S-EPMC9125886 | biostudies-literature
Project description:ObjectivesThis systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to investigate the clinical efficacy and safety of tocilizumab for treating patients with COVID-19.MethodsThe PubMed, Embase, Cochrane Library, Clinicaltrials.gov, WHO International Clinical Trials Registry Platform and the preprint server of medRxiv.org were searched from their inception to February 20, 2021. Only RCTs that compared the treatment efficacy and safety of tocilizumab with the placebo or the standard of care for adult patients with COVID-19 were included in this meta-analysis. The primary outcome was 28-day mortality.ResultsThis meta-analysis included eight RCTs which enrolled a total of 6314 patients for randomization, in which 3267 and 3047 patients were assigned to the tocilizumab and control groups, respectively. The mortality at day 28 was 24.4% and 29.9% in patients in the tocilizumab and control groups, respectively, meaning there was no significant difference observed between these two groups (OR, 0.92; 95% CI, 0.66-1.28; I2 = 62). This finding did not change in the subgroup analysis according to the initial use of MV or steroid while enrollment. The patients receiving tocilizumab had a lower rate of mechanical ventilation (MV) and intensive care unit (ICU) admission at day 28 compared with the control group (MV use: OR, 0.75; 95% CI, 0.62-0.90; I2 = 11; ICU admission: OR, 0.51; 95% CI, 0.28-0.92; I2 = 30). There were no significant differences between these two treatment groups in terms of the risk of treatment-emergent adverse events (AEs) (OR, 1.03; 95% CI, 0.71-1.49; I2 = 43), serious AEs (OR, 0.86; 95% CI, 0.67-1.12; I2 = 0) or infection (OR, 0.87; 95% CI, 0.63-1.20; I2 = 0).ConclusionsTocilizumab does not provide a survival benefit for patients with COVID-19, but it may help reduce the risk of MV and ICU admission. In addition, tocilizumab is a safe agent to use for the treatment of COVID-19.
| S-EPMC7988468 | biostudies-literature
Project description:ObjectiveRisk factors for in-hospital mortality in confirmed COVID-19 patients have been summarized in numerous meta-analyses, but it is still unclear whether they vary according to the age, sex and health conditions of the studied populations. This study explored these variables as potential mortality predictors.MethodsA systematic review was conducted by searching the MEDLINE, Scopus, and Web of Science databases of studies available through July 27, 2020. The pooled risk was estimated with the odds ratio (p-OR) or effect size (p-ES) obtained through random-effects meta-analyses. Subgroup analyses and meta-regression were applied to explore differences by age, sex and health conditions. The MOOSE guidelines were strictly followed.ResultsThe meta-analysis included 60 studies, with a total of 51,225 patients (12,458 [24.3%] deaths) from hospitals in 13 countries. A higher in-hospital mortality risk was found for dyspnoea (p-OR = 2.5), smoking (p-OR = 1.6) and several comorbidities (p-OR range: 1.8 to 4.7) and laboratory parameters (p-ES range: 0.3 to -2.6). Age was the main source of heterogeneity, followed by sex and health condition. The following predictors were more markedly associated with mortality in studies with patients with a mean age ≤60 years: dyspnoea (p-OR = 4.3), smoking (p-OR = 2.8), kidney disease (p-OR = 3.8), hypertension (p-OR = 3.7), malignancy (p-OR = 3.7), diabetes (p-OR = 3.2), pulmonary disease (p-OR = 3.1), decreased platelet count (p-ES = -1.7), decreased haemoglobin concentration (p-ES = -0.6), increased creatinine (p-ES = 2.4), increased interleukin-6 (p-ES = 2.4) and increased cardiac troponin I (p-ES = 0.7). On the other hand, in addition to comorbidities, the most important mortality predictors in studies with older patients were albumin (p-ES = -3.1), total bilirubin (p-ES = 0.7), AST (p-ES = 1.8), ALT (p-ES = 0.4), urea nitrogen (p-ES), C-reactive protein (p-ES = 2.7), LDH (p-ES = 2.4) and ferritin (p-ES = 1.7). Obesity was associated with increased mortality only in studies with fewer chronic or critical patients (p-OR = 1.8).ConclusionThe prognostic effect of clinical conditions on COVID-19 mortality vary substantially according to the mean age of patients.Prospero registration numberCRD42020176595.
| S-EPMC7608886 | biostudies-literature