Frontiers in Medicine (Jan 2021)
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,
- Alessandro Maloberti,
- Oscar Epis,
- Cristina Giannattasio,
- Cristina Giannattasio,
- Claudio Rossetti,
- Livije Kalogjera,
- Jasminka Peršec,
- Jasminka Peršec,
- Luke Ollivere,
- Benjamin J. Ollivere,
- Huadong Yan,
- Huadong Yan,
- Ting Cai,
- Guruprasad P. Aithal,
- Claire J. Steves,
- Anu Kantele,
- Mikael Kajova,
- Olli Vapalahti,
- Olli Vapalahti,
- Antti Sajantila,
- Antti Sajantila,
- Rafal Wojtowicz,
- Waldemar Wierzba,
- Zbigniew Krol,
- Artur Zaczynski,
- Katarina Zycinska,
- Katarina Zycinska,
- Marek Postula,
- Ivica Lukšić,
- Rok Čivljak,
- Rok Čivljak,
- Rok Čivljak,
- Alemka Markotić,
- Johannes Brachmann,
- Johannes Brachmann,
- Andreas Markl,
- Christian Mahnkopf,
- Benjamin Murray,
- Sebastien Ourselin,
- Ana M. Valdes,
- Juan P. Horcajada,
- Xavier Castells,
- Julio Pascual,
- Massimo Allegri,
- Dragan Primorac,
- Dragan Primorac,
- Dragan Primorac,
- Dragan Primorac,
- Dragan Primorac,
- Dragan Primorac,
- Tim D. Spector,
- Clara Barrios,
- Gordan Lauc,
- Gordan Lauc
Affiliations
- Domagoj Kifer
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
- Dario Bugada
- Emergency and Intensive Care Department, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII Hospital, Bergamo, Italy
- Judit Villar-Garcia
- Hospital del Mar-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Ivan Gudelj
- Genos Glycoscience Research Laboratory, Zagreb, Croatia
- Cristina Menni
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Carole Sudre
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Frano Vučković
- Genos Glycoscience Research Laboratory, Zagreb, Croatia
- Ivo Ugrina
- Faculty of Science, University of Split, Split, Croatia
- Luca F. Lorini
- Emergency and Intensive Care Department, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII Hospital, Bergamo, Italy
- Margarita Posso
- Hospital del Mar-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Silvia Bettinelli
- Emergency and Intensive Care Department, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII Hospital, Bergamo, Italy
- Nicola Ughi
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Alessandro Maloberti
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Alessandro Maloberti
- School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy
- Oscar Epis
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Cristina Giannattasio
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Cristina Giannattasio
- School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy
- Claudio Rossetti
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Livije Kalogjera
- Department of Otolaryngology-Head and Neck Surgery, Zagreb School of Medicine, University Hospital Centre “Sestre milosrdnice”, Zagreb, Croatia
- Jasminka Peršec
- 0Clinical Department of Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava Zagreb, Zagreb, Croatia
- Jasminka Peršec
- 1University of Zagreb School of Dental Medicine, Zagreb, Croatia
- Luke Ollivere
- 2National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust and the University of Nottingham, Nottingham, United Kingdom
- Benjamin J. Ollivere
- 2National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust and the University of Nottingham, Nottingham, United Kingdom
- Huadong Yan
- 3Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Department of Infectious Diseases, Hwamei Hospital, University of Chinese Academy of Sciences, Ningbo, China
- Huadong Yan
- 4Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
- Ting Cai
- 3Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Department of Infectious Diseases, Hwamei Hospital, University of Chinese Academy of Sciences, Ningbo, China
- Guruprasad P. Aithal
- 2National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust and the University of Nottingham, Nottingham, United Kingdom
- Claire J. Steves
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Anu Kantele
- 5Inflammation Centre, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Mikael Kajova
- 5Inflammation Centre, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Olli Vapalahti
- 6Department of Virology, Helsingin ja Uudenmaan Sairaanhoitopiiri Diagnostic Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Olli Vapalahti
- 7Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland
- Antti Sajantila
- 8Department of Forensic Medicine, University of Helsinki, Helsinki, Finland
- Antti Sajantila
- 9Forensic Medicine Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Rafal Wojtowicz
- 0Central Clinical Hospital of Ministry of the Interior and Administration, Warsaw, Poland
- Waldemar Wierzba
- 0Central Clinical Hospital of Ministry of the Interior and Administration, Warsaw, Poland
- Zbigniew Krol
- 0Central Clinical Hospital of Ministry of the Interior and Administration, Warsaw, Poland
- Artur Zaczynski
- 0Central Clinical Hospital of Ministry of the Interior and Administration, Warsaw, Poland
- Katarina Zycinska
- 0Central Clinical Hospital of Ministry of the Interior and Administration, Warsaw, Poland
- Katarina Zycinska
- 1Medical University of Warsaw, Warsaw, Poland
- Marek Postula
- 2Department of Experimental and Clinical Pharmacology, Center for Preclinical Research and Technology CEPT, Medical University of Warsaw, Warsaw, Poland
- Ivica Lukšić
- 3University of Zagreb School of Medicine, University Hospital Dubrava, Zagreb, Croatia
- Rok Čivljak
- 4University Hospital for Infectious Diseases “Fran Mihaljević”, University of Zagreb School of Medicine, Zagreb, Croatia
- Rok Čivljak
- 5University Hospital for Infectious Diseases “Fran Mihaljević”, Catholic University of Croatia, Zagreb, Croatia
- Rok Čivljak
- 6Medical School, University of Rijeka, Rijeka, Croatia
- Alemka Markotić
- 4University Hospital for Infectious Diseases “Fran Mihaljević”, University of Zagreb School of Medicine, Zagreb, Croatia
- Johannes Brachmann
- 7REGIOMED Kliniken, Coburg, Germany
- Johannes Brachmann
- 8University of Split School of Medicine, Split, Croatia
- Andreas Markl
- 7REGIOMED Kliniken, Coburg, Germany
- Christian Mahnkopf
- 7REGIOMED Kliniken, Coburg, Germany
- Benjamin Murray
- 9School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Sebastien Ourselin
- 9School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
- Ana M. Valdes
- 2National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust and the University of Nottingham, Nottingham, United Kingdom
- Juan P. Horcajada
- Hospital del Mar-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Xavier Castells
- Hospital del Mar-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Julio Pascual
- Hospital del Mar-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Massimo Allegri
- 0Pain Therapy Service Policlinico of Monza Hospital, Monza, Italy
- Dragan Primorac
- 7REGIOMED Kliniken, Coburg, Germany
- Dragan Primorac
- 8University of Split School of Medicine, Split, Croatia
- Dragan Primorac
- 1St. Catharine Hospital, Zagreb, Croatia
- Dragan Primorac
- 2Eberly College of Science, Penn State University, University Park, PA, United States
- Dragan Primorac
- 3University of Osijek School of Medicine, Osijek, Croatia
- Dragan Primorac
- 4Faculty of Dental Medicine and Health, University of Rijeka School of Medicine, University of Rijeka, Rijeka, Croatia
- Tim D. Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Clara Barrios
- Hospital del Mar-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Gordan Lauc
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
- Gordan Lauc
- Genos Glycoscience Research Laboratory, Zagreb, Croatia
- DOI
- https://doi.org/10.3389/fmed.2020.607786
- Journal volume & issue
-
Vol. 7
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
