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

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

doi:10.3389/fmed.2020.607786

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

Domagoj Kifer, Dario Bugada, Judit Villar-Garcia, Ivan Gudelj, Cristina Menni, Carole Sudre, Frano Vučković, Ivo Ugrina, Luca F. Lorini, Margarita Posso, Silvia Bettinelli, Nicola Ughi, Alessandro Maloberti, Oscar Epis, Cristina Giannattasio, Claudio Rossetti, Livije Kalogjera, Jasminka Peršec, Luke Ollivere, Benjamin J. OllivereHuadong Yan, Ting Cai, Guruprasad P. Aithal, Claire J. Steves, Anu Kantele, Mikael Kajova, Olli Vapalahti, Antti Sajantila, Rafal Wojtowicz, Waldemar Wierzba, Zbigniew Krol, Artur Zaczynski, Katarina Zycinska, Marek Postula, Ivica Lukšić, Rok Čivljak, Alemka Markotić, Johannes Brachmann, Andreas Markl, Christian Mahnkopf, Benjamin Murray, Sebastien Ourselin, Ana M. Valdes, Juan P. Horcajada, Xavier Castells, Julio Pascual, Massimo Allegri, Dragan Primorac, Tim D. Spector, Clara Barrios, Gordan Lauc^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

37 Citations (Scopus)

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.

Original language	English
Article number	607786
Journal	Frontiers in Medicine
Volume	7
DOIs	https://doi.org/10.3389/fmed.2020.607786
Publication status	Published - 20 Jan 2021

Keywords

COVID-19
humidity
mortality
mucins
seasonality

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3389/fmed.2020.607786

Cite this

Kifer, D., Bugada, D., Villar-Garcia, J., Gudelj, I., Menni, C., Sudre, C., Vučković, F., Ugrina, I., Lorini, L. F., Posso, M., Bettinelli, S., Ughi, N., Maloberti, A., Epis, O., Giannattasio, C., Rossetti, C., Kalogjera, L., Peršec, J., Ollivere, L., ... Lauc, G. (2021). Effects of Environmental Factors on Severity and Mortality of COVID-19. Frontiers in Medicine, 7, Article 607786. https://doi.org/10.3389/fmed.2020.607786

@article{0c6a21e28c234a8a87bca018dfdf1c3b,

title = "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.",

keywords = "COVID-19, humidity, mortality, mucins, seasonality",

author = "Domagoj Kifer and Dario Bugada and Judit Villar-Garcia and Ivan Gudelj and Cristina Menni and Carole Sudre and Frano Vu{\v c}kovi{\'c} and Ivo Ugrina and Lorini, {Luca F.} and Margarita Posso and Silvia Bettinelli and Nicola Ughi and Alessandro Maloberti and Oscar Epis and Cristina Giannattasio and Claudio Rossetti and Livije Kalogjera and Jasminka Per{\v s}ec and Luke Ollivere and Ollivere, {Benjamin J.} and Huadong Yan and Ting Cai and Aithal, {Guruprasad P.} and Steves, {Claire J.} and Anu Kantele and Mikael Kajova and Olli Vapalahti and Antti Sajantila and Rafal Wojtowicz and Waldemar Wierzba and Zbigniew Krol and Artur Zaczynski and Katarina Zycinska and Marek Postula and Ivica Luk{\v s}i{\'c} and Rok {\v C}ivljak and Alemka Markoti{\'c} and Johannes Brachmann and Andreas Markl and Christian Mahnkopf and Benjamin Murray and Sebastien Ourselin and Valdes, {Ana M.} and Horcajada, {Juan P.} and Xavier Castells and Julio Pascual and Massimo Allegri and Dragan Primorac and Spector, {Tim D.} and Clara Barrios and Gordan Lauc",

note = "Funding Information: We would like to thank all anaesthesiologists and nurses in the emergency and intensive care unit, as well as all the people who worked at ASST Papa Giovanni XXIII during the COVID-19 pandemic in Bergamo for their invaluable and brave efforts toward patient's care. We also want to acknowledge the ROCCO Project (Registry of Coronavirus Complications) who helped with scientific support and Dr. A. Bonetalli (Epidemiology Office, ASST Papa Giovanni XXIII, Bergamo, Italy) for her help with data collection. We thank all the medical professionals, nurses, and technicians of the ASST GOM Niguarda Hospital who worked hard during the COVID 19 emergency months. Furthermore, we want to acknowledge all the member of the COVID 19 Niguarda Working Group. We express our sincere thanks to all the participants of the COVID Symptom Study app. We thank the staff of Zoe Global Limited, the Department of Twin Research, and the Clinical and Translational Epidemiology Unit for their tireless work in contributing to the running of the study and data collection. This manuscript has been released as a pre-print at MedRxiv, https://www.medrxiv.org/content/10.1101/2020.07.11.20147157v2. Funding. This work was supported in part by the European Structural and Investment Funds grant for the National Centre of Competence in Molecular Diagnostics (#KK.01.2.2.03.0006), a National Centre of Research Excellence in Personalized Healthcare grant (#KK.01.1.1.01.0010), and an IP CORONA-2020-04 grant from the Croatian Science Foundation. The Symptom Study app: Zoe provided in kind support for all aspects of building, running, and supporting the app and service to all users worldwide. The Department of Twin Research receives support from grants from the Wellcome Trust (212904/Z/18/Z) and the Medical Research Council (MRC)/British Heart Foundation Ancestry and Biological Informative Markers for Stratification of Hypertension (AIMHY; MR/M016560/1), European Union, Chronic Disease Research Foundation (CDRF), Zoe Global Ltd, NIH, and the National Institute for Health Research (NIHR)-funded BioResource, Clinical Research Facility and Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust in partnership with King's College London. CMe was funded by the Chronic Disease Research Foundation and by the MRC Aim-Hy project grant. CB was funded by grants FIS-FEDER-ISCIII PI16/00620 and PERIS STL008. Publisher Copyright: {\textcopyright} Copyright {\textcopyright} 2021 Kifer, Bugada, Villar-Garcia, Gudelj, Menni, Sudre, Vu{\v c}kovi{\'c}, Ugrina, Lorini, Posso, Bettinelli, Ughi, Maloberti, Epis, Giannattasio, Rossetti, Kalogjera, Per{\v s}ec, Ollivere, Ollivere, Yan, Cai, Aithal, Steves, Kantele, Kajova, Vapalahti, Sajantila, Wojtowicz, Wierzba, Krol, Zaczynski, Zycinska, Postula, Luk{\v s}i{\'c}, {\v C}ivljak, Markoti{\'c}, Brachmann, Markl, Mahnkopf, Murray, Ourselin, Valdes, Horcajada, Castells, Pascual, Allegri, Primorac, Spector, Barrios and Lauc. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = jan,

day = "20",

doi = "10.3389/fmed.2020.607786",

language = "English",

volume = "7",

journal = "Frontiers in Medicine",

issn = "2296-858X",

publisher = "Frontiers Media S.A.",

}

Kifer, D, Bugada, D, Villar-Garcia, J, Gudelj, I, Menni, C , Sudre, C, Vučković, F, Ugrina, I, Lorini, LF, Posso, M, Bettinelli, S, Ughi, N, Maloberti, A, Epis, O, Giannattasio, C, Rossetti, C, Kalogjera, L, Peršec, J, Ollivere, L, Ollivere, BJ, Yan, H, Cai, T, Aithal, GP, Steves, CJ, Kantele, A, Kajova, M, Vapalahti, O, Sajantila, A, Wojtowicz, R, Wierzba, W, Krol, Z, Zaczynski, A, Zycinska, K, Postula, M, Lukšić, I, Čivljak, R, Markotić, A, Brachmann, J, Markl, A, Mahnkopf, C, Murray, B , Ourselin, S, Valdes, AM, Horcajada, JP, Castells, X, Pascual, J, Allegri, M, Primorac, D, Spector, TD, Barrios, C & Lauc, G 2021, 'Effects of Environmental Factors on Severity and Mortality of COVID-19', Frontiers in Medicine, vol. 7, 607786. https://doi.org/10.3389/fmed.2020.607786

TY - JOUR

T1 - Effects of Environmental Factors on Severity and Mortality of COVID-19

AU - Kifer, Domagoj

AU - Bugada, Dario

AU - Villar-Garcia, Judit

AU - Gudelj, Ivan

AU - Menni, Cristina

AU - Sudre, Carole

AU - Vučković, Frano

AU - Ugrina, Ivo

AU - Lorini, Luca F.

AU - Posso, Margarita

AU - Bettinelli, Silvia

AU - Ughi, Nicola

AU - Maloberti, Alessandro

AU - Epis, Oscar

AU - Giannattasio, Cristina

AU - Rossetti, Claudio

AU - Kalogjera, Livije

AU - Peršec, Jasminka

AU - Ollivere, Luke

AU - Ollivere, Benjamin J.

AU - Yan, Huadong

AU - Cai, Ting

AU - Aithal, Guruprasad P.

AU - Steves, Claire J.

AU - Kantele, Anu

AU - Kajova, Mikael

AU - Vapalahti, Olli

AU - Sajantila, Antti

AU - Wojtowicz, Rafal

AU - Wierzba, Waldemar

AU - Krol, Zbigniew

AU - Zaczynski, Artur

AU - Zycinska, Katarina

AU - Postula, Marek

AU - Lukšić, Ivica

AU - Čivljak, Rok

AU - Markotić, Alemka

AU - Brachmann, Johannes

AU - Markl, Andreas

AU - Mahnkopf, Christian

AU - Murray, Benjamin

AU - Ourselin, Sebastien

AU - Valdes, Ana M.

AU - Horcajada, Juan P.

AU - Castells, Xavier

AU - Pascual, Julio

AU - Allegri, Massimo

AU - Primorac, Dragan

AU - Spector, Tim D.

AU - Barrios, Clara

AU - Lauc, Gordan

N1 - Funding Information: We would like to thank all anaesthesiologists and nurses in the emergency and intensive care unit, as well as all the people who worked at ASST Papa Giovanni XXIII during the COVID-19 pandemic in Bergamo for their invaluable and brave efforts toward patient's care. We also want to acknowledge the ROCCO Project (Registry of Coronavirus Complications) who helped with scientific support and Dr. A. Bonetalli (Epidemiology Office, ASST Papa Giovanni XXIII, Bergamo, Italy) for her help with data collection. We thank all the medical professionals, nurses, and technicians of the ASST GOM Niguarda Hospital who worked hard during the COVID 19 emergency months. Furthermore, we want to acknowledge all the member of the COVID 19 Niguarda Working Group. We express our sincere thanks to all the participants of the COVID Symptom Study app. We thank the staff of Zoe Global Limited, the Department of Twin Research, and the Clinical and Translational Epidemiology Unit for their tireless work in contributing to the running of the study and data collection. This manuscript has been released as a pre-print at MedRxiv, https://www.medrxiv.org/content/10.1101/2020.07.11.20147157v2. Funding. This work was supported in part by the European Structural and Investment Funds grant for the National Centre of Competence in Molecular Diagnostics (#KK.01.2.2.03.0006), a National Centre of Research Excellence in Personalized Healthcare grant (#KK.01.1.1.01.0010), and an IP CORONA-2020-04 grant from the Croatian Science Foundation. The Symptom Study app: Zoe provided in kind support for all aspects of building, running, and supporting the app and service to all users worldwide. The Department of Twin Research receives support from grants from the Wellcome Trust (212904/Z/18/Z) and the Medical Research Council (MRC)/British Heart Foundation Ancestry and Biological Informative Markers for Stratification of Hypertension (AIMHY; MR/M016560/1), European Union, Chronic Disease Research Foundation (CDRF), Zoe Global Ltd, NIH, and the National Institute for Health Research (NIHR)-funded BioResource, Clinical Research Facility and Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust in partnership with King's College London. CMe was funded by the Chronic Disease Research Foundation and by the MRC Aim-Hy project grant. CB was funded by grants FIS-FEDER-ISCIII PI16/00620 and PERIS STL008. Publisher Copyright: © Copyright © 2021 Kifer, Bugada, Villar-Garcia, Gudelj, Menni, Sudre, Vučković, Ugrina, Lorini, Posso, Bettinelli, Ughi, Maloberti, Epis, Giannattasio, Rossetti, Kalogjera, Peršec, Ollivere, Ollivere, Yan, Cai, Aithal, Steves, Kantele, Kajova, Vapalahti, Sajantila, Wojtowicz, Wierzba, Krol, Zaczynski, Zycinska, Postula, Lukšić, Čivljak, Markotić, Brachmann, Markl, Mahnkopf, Murray, Ourselin, Valdes, Horcajada, Castells, Pascual, Allegri, Primorac, Spector, Barrios and Lauc. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/1/20

Y1 - 2021/1/20

N2 - 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.

AB - 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.

KW - COVID-19

KW - humidity

KW - mortality

KW - mucins

KW - seasonality

UR - http://www.scopus.com/inward/record.url?scp=85100600449&partnerID=8YFLogxK

U2 - 10.3389/fmed.2020.607786

DO - 10.3389/fmed.2020.607786

M3 - Article

AN - SCOPUS:85100600449

SN - 2296-858X

VL - 7

JO - Frontiers in Medicine

JF - Frontiers in Medicine

M1 - 607786

ER -

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

Abstract

Keywords

UN SDGs

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