Palmer Raymond F, Kattari David, Verduzco-Gutierrez Monica
Family and Community Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
Kattari Consulting, Cayucos, California, USA.
Fam Med Community Health. 2025 Apr 24;13(2):e003081. doi: 10.1136/fmch-2024-003081.
The purpose of this study was to determine if the COVID-19 pandemic had differential effects on individuals with chemical intolerances (CI). CI is characterised by multisystem symptoms initiated by a one-time high dose or persistent low-dose exposure to environmental toxins including chemicals, foods and drugs. With an estimated 20% US prevalence, symptoms include fatigue, headache, weakness, rash, mood changes, musculoskeletal pain, gastrointestinal issues, difficulties with memory, concentration and respiratory problems, which are similar to COVID-19 and its sequelae.
A US population-based survey involving 7500 respondents was asked if they ever had COVID-19, what the severity was, and if they had long COVID-19. CI was assessed using the Quick Environmental Exposure and Sensitivity Inventory.
The Center for Disease Control estimates that over 24 million have been infected with COVID-19 in the USA with over 6 700 000 being hospitalised and over 1 174 000 deaths. Other industrialised countries show similar numbers.
Those in the High CI class reported a greater COVID-19 prevalence, symptom severity and long COVID-19 than in the medium and low CI groups (p<0.0001). These associations were independent of race, ethnicity, income, age and sex. However, there were significantly increased odds of COVID-19 severity among women and those over 45 years old. Asian individuals were least likely to have severe symptoms compared with white individuals (OR=0.53; 95% CI 0.35 to 0.79). Black/African American individuals reported a lower prevalence of COVID-19 than non-Hispanic whites. However, one interaction between CI and race was significant, African Americans with high CI reported greater odds (OR=2.2; 95% CI 1.15 to 3.16) of reporting COVID-19 prevalence. Furthermore, African American individuals had significantly greater odds of increased symptom severity.
Prior studies show higher risk for COVID-19 among older age groups, male sex, those with pre-existing comorbidities (eg, challenged immunities) and those from minoritised racial/ethnic groups. The results of this study suggest that those with CI be included in a high-risk group. Various risk subsets may exist and future investigations could identify different risk subsets. Understanding these subgroups would be helpful in mounting targeted prevention efforts.
本研究旨在确定新冠疫情对化学不耐受（CI）个体是否有不同影响。CI的特征是由一次性高剂量或持续性低剂量接触包括化学物质、食物和药物在内的环境毒素引发的多系统症状。据估计，美国CI患病率为20%，症状包括疲劳、头痛、虚弱、皮疹、情绪变化、肌肉骨骼疼痛、胃肠道问题、记忆和注意力障碍以及呼吸问题，这些与新冠及其后遗症相似。
一项基于美国人群的调查，询问了7500名受访者是否感染过新冠、病情严重程度以及是否患有新冠长期症状。使用快速环境暴露与敏感性量表评估CI。
疾病控制中心估计，美国有超过2400万人感染过新冠，其中超过670万人住院，超过117.4万人死亡。其他工业化国家也有类似数字。
高CI组报告的新冠患病率、症状严重程度和新冠长期症状高于中CI组和低CI组（p<0.0001）。这些关联独立于种族、民族、收入、年龄和性别。然而，女性和45岁以上人群中新冠病情严重的几率显著增加。与白人相比，亚洲人出现严重症状的可能性最小（比值比=0.53；95%置信区间0.35至0.79）。黑人/非裔美国人报告的新冠患病率低于非西班牙裔白人。然而，CI与种族之间的一种相互作用具有显著性，高CI的非裔美国人报告新冠患病率的几率更高（比值比=2.2；95%置信区间1.15至3.16）。此外，非裔美国人症状严重程度增加的几率显著更高。
先前的研究表明，年龄较大、男性、有基础合并症（如免疫功能受损）以及少数族裔群体感染新冠的风险更高。本研究结果表明，CI患者应被纳入高危人群。可能存在各种风险亚组，未来的调查可以识别不同的风险亚组。了解这些亚组将有助于开展有针对性的预防工作。
