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新型冠状病毒肺炎(COVID-19)- 可能与因接触各种危害生物气溶胶而导致的呼吸道合并症的相互关系。第一部分:大流行的发生、流行病学和推测起源。

COVID 19 - Possible interrelations with respiratory comorbidities caused by occupational exposure to various hazardous bioaerosols. Part I. Occurrence, epidemiology and presumed origin of the pandemic.

机构信息

Department of Biological Health Hazards and Parasitology, Institute of Rural Heath, Lublin, Poland.

Department of Pneumonology, Oncology and Allergology, Medical University, Lublin, Poland.

出版信息

Ann Agric Environ Med. 2020 Dec 22;27(4):491-504. doi: 10.26444/aaem/130871. Epub 2020 Dec 8.

Abstract

The occupational bioaerosols containing viruses, bacteria, fungi, microbial toxins and plant or animal particles, may evoke infectious, allergic or immunotoxic diseases which may co-exist as comorbidities with COVID-19 and exacerbate the course of disease. They include hypersensitivity pneumonitis (HP) caused mostly by bacteria, fungi, and particles containing animal proteins, and immunotoxic diseases such as organic dust toxic syndrome (ODTS) and byssinosis, caused mostly by bacterial and fungal toxins. The two most probable scenarios of possible interrelations between these three comorbidities (CM) and COVID-19 are: 1) 'Triggering' - when infection with SARS-CoV-2 triggers severe CM after bioaerosol exposure; 2) 'Reverse triggering' when exposure to bioaerosol exacerbates a symptomless or mild course of COVID-19, and evokes a severe disease. The occupations mostly endangered by COVID-19 as the result of exposure to SARS-CoV-2 bioaerosol, or to other bioaerosols which may exacerbate this disease, include: health care workers, social workers, breeders of fur animals, slaughterhouse workers, workers engaged in the processing and selling of seafood, and probably also agricultural workers, mainly in the developing countries. The authors present a hypothesis for the origin of the present pandemic. It assumes that a mild form of the present SARS-CoV-2 that is supposedly circulating among the Chinese population in the eastern part of the country, mutated under the influence of as yet unknown factor(s) present in the Chinese seafood markets, probably component(s) of bioaerosols, into the virulent and highly contagious form, known as the present SARS-CoV-2, under a scenario similar to that the authors have named 'Reverse triggering'.

摘要

职业性生物气溶胶中含有病毒、细菌、真菌、微生物毒素以及植物或动物颗粒,可能会引发传染性、过敏性或免疫毒性疾病,这些疾病可能与 COVID-19 同时存在,并使疾病恶化。其中包括主要由细菌、真菌和含有动物蛋白的颗粒引起的过敏性肺炎(HP),以及主要由细菌和真菌毒素引起的有机粉尘毒性综合征(ODTS)和棉尘病等免疫毒性疾病。这三种合并症(CM)与 COVID-19 之间可能存在的两种最可能的相互关系情景是:1)“触发”——当 SARS-CoV-2 感染在生物气溶胶暴露后引发严重的 CM;2)“反向触发”——当暴露于生物气溶胶使无症状或轻度 COVID-19 恶化,并引发严重疾病时。由于暴露于 SARS-CoV-2 生物气溶胶或其他可能加重这种疾病的生物气溶胶,面临 COVID-19 风险最大的职业包括:医护人员、社会工作者、毛皮动物饲养员、屠宰场工人、从事海鲜加工和销售的工人,可能还包括农业工人,主要在发展中国家。作者提出了一种关于当前大流行起源的假说。该假说假设,目前在该国东部中国人群中传播的 SARS-CoV-2 的轻度形式,在目前尚不清楚的中国海鲜市场存在的因素(可能是生物气溶胶的成分)的影响下发生了突变,变成了目前的 SARS-CoV-2,这种形式类似于作者所称的“反向触发”。

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