Is There a Role for Environmental and Metabolic Factors Predisposing
                    to Severe COVID-19?

Stefan R. Bornstein; Karin Voit-Bak; Dieter Schmidt; Henning Morawietz; Alexander Benjamin Bornstein; Waldimir Balanzew; Ulrich Julius; Roman N. Rodionov; Anne Maria Biener; Jun Wang; Klaus-Martin Schulte; Peter Krebs; Günter Vollmer; R. Straube

doi:10.1055/a-1182-2016

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2020; 52(07): 540-546
DOI: 10.1055/a-1182-2016

Hypothesis

Is There a Role for Environmental and Metabolic Factors Predisposing to Severe COVID-19?

Stefan R. Bornstein

¹Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore

²Department of Medicine III, University Hospital Carl Gustav Carus at the Technische Universität, Dresden, Germany

³Department of Diabetes, School of Life Course Science and Medicine, Kingʼs College London, London, UK

⁴Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, University Hospital, Zürich, Switzerland

,

Karin Voit-Bak

⁵Zentrum für Apherese- und Hämofiltration am INUS Tagesklinikum-Cham, Cham, Germany

,

Dieter Schmidt

⁵Zentrum für Apherese- und Hämofiltration am INUS Tagesklinikum-Cham, Cham, Germany

,

Henning Morawietz

⁶Division of Vascular Endothelium and Microcirculation, Department of Medicine III, University Hospital Carl Gustav Carus at the Technische Universität, Dresden, Germany

,

Alexander Benjamin Bornstein

²Department of Medicine III, University Hospital Carl Gustav Carus at the Technische Universität, Dresden, Germany

,

Waldimir Balanzew

²Department of Medicine III, University Hospital Carl Gustav Carus at the Technische Universität, Dresden, Germany

,

Ulrich Julius

²Department of Medicine III, University Hospital Carl Gustav Carus at the Technische Universität, Dresden, Germany

,

Roman N. Rodionov

²Department of Medicine III, University Hospital Carl Gustav Carus at the Technische Universität, Dresden, Germany

,

Anne Maria Biener

²Department of Medicine III, University Hospital Carl Gustav Carus at the Technische Universität, Dresden, Germany

,

Jun Wang

²Department of Medicine III, University Hospital Carl Gustav Carus at the Technische Universität, Dresden, Germany

,

Klaus-Martin Schulte

⁷Department of Endocrine Surgery, King's College Hospital NHS Foundation Trust, London, UK

⁸ACRF Department of Cancer, John Curtin School of Medical Research, The Australian National University, Canberra, Australia

,

Peter Krebs

⁹Institute of Urban and Industrial Water Management, Technische Universität Dresden, Dresden, Germany

,

Günter Vollmer

¹⁰Institute of Zoology, Molecular Cell Physiology and Endocrinology, Technische Universität Dresden, Dresden, Germany

,

R. Straube

⁵Zentrum für Apherese- und Hämofiltration am INUS Tagesklinikum-Cham, Cham, Germany

› Author Affiliations

Abstract

The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic affects people around the world. However, there have been striking differences in the number of infected individuals and deaths in different countries. Particularly, within Central Europe in countries that are similar in ethnicity, age, and medical standards and have performed similar steps of containment, such differences in mortality rates remain inexplicable. We suggest to consider and explore environmental factors to explain these intriguing variations. Countries like Northern Italy, France, Spain, and UK have suffered from 5 times more deaths from the corona virus infection than neighboring countries like Germany, Switzerland, Austria, and Denmark related to the size of their respective populations. There is a striking correlation between the level of environmental pollutants including pesticides, dioxins, and air pollution such as NO₂ known to affect immune function and healthy metabolism with the rate of mortality in COVID-19 pandemic in these European countries. There is also a correlation with the use of chlorination of drinking water in these regions. In addition to the improvement of environmental protective programs, there are possibilities to lower the blood levels of these pollutants by therapeutic apheresis. Furthermore, therapeutic apheresis might be an effective method to improve metabolic inflammation, altered vascular perfusion, and neurodegeneration observed as long-term complications of COVID-19 disease.

Key words

COVID-19 - environmental pollution - apheresis - chlorinated water

Full Text

References

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