Is There a Role for Environmental and Metabolic Factors Predisposing to Severe COVID-19?Funding Information This work was supported by the Deutsche Forschungsgemeinschaft (DFG) (grant numbers MO 1695/5-1 and -2) and the Excellence Initiative by the German Federal State Governments (Institutional Strategy, measure “support the best”, grant number 3-2, F03661- 553-41B-1250000). Klaus-Martin Schulte is supported by the Max Lindemann Memorial Fund.
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.
Received: 08 May 2020
Accepted: 15 May 2020
29 June 2020 (online)
© Georg Thieme Verlag KG
Stuttgart · New York
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