IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; Federal Research Centre of Biological Systems and Agro-technologies of the Russian Academy of Sciences, Orenburg, Russia.
São Paulo State University - UNESP, Center for Evaluation of Environmental Impact on Human Health (TOXICAM), Botucatu, SP, Brazil; Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, USA.
Food Chem Toxicol. 2020 Dec;146:111809. doi: 10.1016/j.fct.2020.111809. Epub 2020 Oct 16.
Multiple medical, lifestyle, and environmental conditions, including smoking and particulate pollution, have been considered as risk factors for COronaVIrus Disease 2019 (COVID-19) susceptibility and severity. Taking into account the high level of toxic metals in both particulate matter (PM2.5) and tobacco smoke, the objective of this review is to discuss recent data on the role of heavy metal exposure in development of respiratory dysfunction, immunotoxicity, and severity of viral diseases in epidemiological and experimental studies, as to demonstrate the potential crossroads between heavy metal exposure and COVID-19 severity risk. The existing data demonstrate that As, Cd, Hg, and Pb exposure is associated with respiratory dysfunction and respiratory diseases (COPD, bronchitis). These observations corroborate laboratory findings on the role of heavy metal exposure in impaired mucociliary clearance, reduced barrier function, airway inflammation, oxidative stress, and apoptosis. The association between heavy metal exposure and severity of viral diseases, including influenza and respiratory syncytial virus has been also demonstrated. The latter may be considered a consequence of adverse effects of metal exposure on adaptive immunity. Therefore, reduction of toxic metal exposure may be considered as a potential tool for reducing susceptibility and severity of viral diseases affecting the respiratory system, including COVID-19.
多种医学、生活方式和环境条件，包括吸烟和颗粒物污染，已被认为是 2019 年冠状病毒病（COVID-19）易感性和严重程度的危险因素。考虑到颗粒物（PM2.5）和烟草烟雾中都存在高水平的有毒金属，本综述的目的是讨论最近关于重金属暴露在呼吸道功能障碍、免疫毒性和病毒疾病严重程度方面的流行病学和实验研究中的作用的相关数据，以证明重金属暴露与 COVID-19 严重风险之间存在潜在的交叉点。现有数据表明，砷、镉、汞和铅暴露与呼吸道功能障碍和呼吸道疾病（COPD、支气管炎）有关。这些观察结果证实了实验室研究的结果，即重金属暴露会损害黏液纤毛清除功能、降低屏障功能、气道炎症、氧化应激和细胞凋亡。重金属暴露与流感和呼吸道合胞病毒等病毒疾病的严重程度之间也存在关联。后者可能是金属暴露对适应性免疫的不良影响的结果。因此，减少有毒金属暴露可能被认为是降低包括 COVID-19 在内的影响呼吸系统的病毒疾病易感性和严重程度的一种潜在工具。
