Environmental pollutant risk factors for worse COVID-19 related clinical outcomes in predominately hispanic and latino populations

Brittney O Baumert; Hongxu Wang; Shar Samy; Sung Kyun Park; Chun Nok Lam; Kathryn Dunn; Brismar Pinto-Pacheco; Douglas Walker; Julio Landero; David Conti; Leda Chatzi; Howard Hu; Jesse A Goodrich

doi:10.1016/j.envres.2024.119072

Environmental pollutant risk factors for worse COVID-19 related clinical outcomes in predominately hispanic and latino populations

Environ Res. 2024 May 8;252(Pt 4):119072. doi: 10.1016/j.envres.2024.119072. Online ahead of print.

Authors

Affiliations

¹ Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
² Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, United States.
³ Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States.
⁴ Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
⁵ Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
⁶ Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States. Electronic address: howard.hu@med.usc.edu.
⁷ Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States. Electronic address: jagoodri@usc.edu.

PMID: 38729411
DOI: 10.1016/j.envres.2024.119072

Abstract

Background: Per- and poly-fluorinated compounds (PFAS) and heavy metals constitute two classes of environmental exposures with known immunotoxicant effects. In this pilot study, we aimed to evaluate the impact of exposure to heavy metals and PFAS on COVID-19 severity. We hypothesized that elevated plasma-PFAS concentrations and urinary heavy metal concentrations would be associated with increased odds of ICU admission in COVID-19 hospitalized individuals.

Methods: Using the University of Southern California Clinical Translational Sciences Institute (SC-CTSI) biorepository of hospitalized COVID-19 patients, urinary concentrations of 15 heavy metals and urinary creatinine were measured in n = 101 patients and plasma concentrations of 13 PFAS were measured in n = 126 patients. COVID-19 severity was determined based on whether a patient was admitted to the ICU during hospitalization. Associations of metals and PFAS with ICU admission were assessed using logistic regression models, controlling for age, sex, ethnicity, smoking status, and for metals, urinary dilution.

Results: The average age of patients was 55 ± 14.2 years. Among SC-CTSI participants with urinary measurement of heavy metals and blood measures of PFAS, 54.5% (n = 61) and 54.8% (n = 80) were admitted to the ICU, respectively. For heavy metals, we observed higher levels of Cd, Cr, and Cu in ICU patients. The strongest associations were with Cadmium (Cd). After accounting for covariates, each 1 SD increase in Cd resulted in a 2.00 (95% CI: 1.10-3.60; p = 0.03) times higher odds of admission to the ICU. When including only Hispanic or Latino participants, the effect estimates between cadmium and ICU admission remained similar. Results for PFAS were less consistent, with perfluorodecanesulfonic acid (PFDS) exhibiting a positive but non-significant association with ICU admission (Odds ratio, 95% CI: 1.50, 0.97-2.20) and perfluorodecanoic acid (PFDA) exhibiting a negative association with ICU admission (0.53, 0.31-0.88).

Conclusions: This study supports the hypothesis that environmental exposures may impact COVID-19 severity.

Keywords: Cadmium; Health disparities; Heavy metals; Per- and polyfluoroalkyl substances; SARs-CoV-2.

Abstract

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