Popescu Irina-Maria, Baditoiu Luminita Mirela, Reddy Sandhya Rani, Nalla Akhila, Popovici Emilian Damian, Margan Madalin-Marius, Anghel Mariana, Laitin Sorina Maria Denisa, Toma Ana-Olivia, Herlo Alexandra, Fericean Roxana Manuela, Baghina Nina, Anghel Andrei
Department of Infectious Diseases, Discipline of Epidemiology, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Doctoral School, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Healthcare (Basel). 2023 Oct 1;11(19):2670. doi: 10.3390/healthcare11192670.
The potential influence of environmental factors, particularly air pollutants such as ozone (O), on the dynamics and progression of COVID-19 remains a significant concern. This study aimed to systematically review and analyze the current body of literature to assess the impact of short-term ozone exposure on COVID-19 transmission dynamics and disease evolution. A rigorous systematic review was conducted in March 2023, covering studies from January 2020 to January 2023 found in PubMed, Web of Science, and Scopus. We followed the PRISMA guidelines and PROSPERO criteria, focusing exclusively on the effects of short-term ozone exposure on COVID-19. The literature search was restricted to English-language journal articles, with the inclusion and exclusion criteria strictly adhered to. Out of 4674 identified studies, 18 fulfilled the inclusion criteria, conducted across eight countries. The findings showed a varied association between short-term ozone exposure and COVID-19 incidence, severity, and mortality. Some studies reported a higher association between ozone exposure and incidence in institutional settings (OR: 1.06, 95% CI: 1.00-1.13) compared to the general population (OR: 1.00, 95% CI: 0.98-1.03). The present research identified a positive association between ozone exposure and both total and active COVID-19 cases as well as related deaths (coefficient for cases: 0.214; for recoveries: 0.216; for active cases: 0.467; for deaths: 0.215). Other studies also found positive associations between ozone levels and COVID-19 cases and deaths, while fewer reports identified a negative association between ozone exposure and COVID-19 incidence (coefficient: -0.187) and mortality (coefficient: -0.215). Conversely, some studies found no significant association between ozone exposure and COVID-19, suggesting a complex and potentially region-specific relationship. The relationship between short-term ozone exposure and COVID-19 dynamics is complex and multifaceted, indicating both positive and negative associations. These variations are possibly due to demographic and regional factors. Further research is necessary to bridge current knowledge gaps, especially considering the potential influence of short-term O exposure on COVID-19 outcomes and the broader implications on public health policy and preventive strategies during pandemics.
环境因素，尤其是臭氧（O）等空气污染物，对新冠病毒疾病（COVID-19）的动态变化和病程发展的潜在影响仍然是一个重大关注点。本研究旨在系统回顾和分析当前的文献，以评估短期臭氧暴露对COVID-19传播动态和疾病演变的影响。2023年3月进行了一项严格的系统回顾，涵盖了在PubMed、科学网（Web of Science）和Scopus数据库中检索到的2020年1月至2023年1月期间的研究。我们遵循了系统评价和荟萃分析的首选报告项目（PRISMA）指南和国际前瞻性系统评价注册库（PROSPERO）标准，专门关注短期臭氧暴露对COVID-19的影响。文献检索仅限于英文期刊文章，并严格遵守纳入和排除标准。在4674项已识别的研究中，有18项符合纳入标准，这些研究来自八个国家。研究结果表明，短期臭氧暴露与COVID-19的发病率、严重程度和死亡率之间的关联各不相同。一些研究报告称，与普通人群相比，机构环境中臭氧暴露与发病率之间的关联更高（比值比：1.06，95%置信区间：1.00-1.13）（普通人群比值比：1.00，95%置信区间：0.98-1.03）。本研究发现臭氧暴露与COVID-19的总病例数和活跃病例数以及相关死亡之间存在正相关（病例系数：0.214；康复系数：0.216；活跃病例系数：0.467；死亡系数：0.215）。其他研究也发现臭氧水平与COVID-19病例数和死亡之间存在正相关，而较少的报告发现臭氧暴露与COVID-19发病率（系数：-0.187）和死亡率（系数：-0.215）之间存在负相关。相反，一些研究发现臭氧暴露与COVID-19之间没有显著关联，这表明两者之间的关系复杂且可能因地区而异。短期臭氧暴露与COVID-19动态变化之间的关系复杂且多方面，显示出正相关和负相关。这些差异可能是由于人口统计学和地区因素造成的。有必要进行进一步的研究以弥合当前的知识差距，特别是考虑短期臭氧暴露对COVID-19结果的潜在影响以及对大流行期间公共卫生政策和预防策略的更广泛影响。
