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[Preprint]. 2020 Oct 26:2020.10.22.20217562.
doi: 10.1101/2020.10.22.20217562.

Severity of COVID-19 at elevated exposure to perfluorinated alkylates

P Grandjean  1   2 , C A G Timmermann  2 , M Kruse  3 , F Nielsen  2 , P Just Vinholt  4 , L Boding  5 , C Heilmann  6 , K Mølbak  5   7
Affiliations

Severity of COVID-19 at elevated exposure to perfluorinated alkylates

P Grandjean et al. medRxiv. .

Update in

Abstract

Background: The course of coronavirus disease 2019 (COVID-19) seems to be aggravated by air pollution, and some industrial chemicals, such as the perfluorinated alkylate substances (PFASs), are immunotoxic and may contribute as well.

Methods: From Danish biobanks, we obtained plasma samples from 323 subjects aged 30-70 years with known SARS-CoV-2 infection. The PFAS concentrations measured at the background exposures included five PFASs known to be immunotoxic. Register data was obtained to classify disease status, other health information, and demographic variables. We used ordinal and ordered logistic regression analyses to determine associations between PFAS concentrations and disease outcome.

Results: Plasma-PFAS concentrations were higher in males, in subjects with Western European background, and tended to increase with age, but were not associated with the presence of chronic disease. Of the study population, 108 (33%) had not been hospitalized, and of those hospitalized, 53 (16%) had been in intensive care or were deceased. Among the five PFASs considered, perfluorobutanoic acid (PFBA) showed an odds ratio (OR) of 2.19 (95% confidence interval, CI, 1.39-3.46) for increasing severities of the disease, although the OR decreased to 1.77 (95% CI, 1.09, 2.87) after adjustment for age, sex, sampling site and interval between blood sampling and diagnosis.

Conclusions: Measures of individual exposures to immunotoxic PFASs included PFBA that accumulates in the lungs. Elevated plasma-PFBA concentrations were associated with an increased risk of more severe course of CIVID-19. Given the low background exposure levels in this study, the role of PFAS exposure in COVID-19 needs to be ascertained in populations with elevated exposures.

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Conflict of interest statement

Declaration of interests Apart from PG having served as health expert in lawsuits on environmental contamination, which does not affect the adherence to all PLOS ONE policies, the authors have no competing interests to declare, financial or otherwise.

Figures

Figure 1.
Figure 1.
Proportion of plasma samples with detectable PFBA concentrations at different disease severities. Results are shown for 44 men and 64 women with up to two weeks of hospitalization, 94 men and 68 women with longer hospitalization, and 36 men and 17 women admitted to the intensive care unit (ICU) or deceased (P = 0.003).
See this image and copyright information in PMC

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