A study of 1,280 patients treated and monitored in the Stony Brook World Trade Center Health and Wellness Program who also contracted COVID-19 reveals that the responders who have suffered from chronic conditions from WTC exposures and the experience of the 911- tragedy, appear to have more infection severity and long-term consequences than responders who do not have chronic illnesses due to WTC exposures. The findings will be published this month in the International Journal of Environmental Research and Public Health†
Led by Benjamin Luft, MD, director of the Stony Brook WTC Health and Wellness Program, and lead author, the study compared patients with WTC-related chronic diseases and patients without such conditions. All patients tested positive for COVID-19. The study participants had a wide range of symptoms or had no symptoms of the infection. They were categorized as moderate (n=536), mild (511), or severe symptoms (104) or asymptomatic (129).
“Our findings point to the need to monitor even more closely these chronically ill patients who have contracted the infection,” said Dr. air. They all suffer from different chronic conditions caused by exposures at the World Trade Center site. This study warns us of even more problems they may face in the future.”
The researchers found that a number of existing chronic conditions appeared to predispose patients to COVID-19-related severity and/or were associated with long-term COVID-19 consequences. For example, they reported that 60 percent of people with severe infections had previously been diagnosed with an upper respiratory illness, and 49 percent with heartburn (GERD), 35 percent have obstructive airway disease and 20 percent have a concomitant psychiatric condition.
Notably, patients found to have significant COVID-19 consequences were measured using self-reported severity scales.
After analyzing the data from each of the participant groups, the researchers found that the severity of COVID-19 was independently associated with age (older with greater severity), black race, obstructive airway disease, and with worse self-reported self-reported disease. depressive symptoms†
dr. Luft and colleagues point out that why some individuals have more severe COVID-19 is not unclear and not fully understood in any population. The same can be said for this population, as scientists continue to explore the full reasons why some people get a serious infection and others don’t.
The authors further write that in their patient cohort, “COVID-19 disease severity was the strongest and the only factor significantly and consistently associated with the major post-acute COVID-19 consequence outcome, as well as symptom-specific categories of post-acute COVID-19 consequences. Taken together, the results add to new evidence that both pre-existing respiratory and mental health conditions play a role risk factors for more severe COVID-19 symptoms, which in turn may put patients at higher risk for long-term health consequences.”
“For a long time, COVID was very common, especially in those individuals with chronic conditions with more severe infection symptoms. In fact, 57 percent of WTC responders with symptoms severe enough to cause hospitalization had persistent COVID symptoms,” said study co-author Sean Clouston , Ph.D. ., associate professor, Department of Family, Population, and Preventive Medicine at the Renaissance School of Medicine, and Program in Public Health.
“As reinfections increase, it is incredibly important that we continue to monitor the impact of COVID on these responders and consider the possibility that these COVID infections have already left a lasting impression on this group and much of public health.” he emphasizes.
dr. Luft says this patient population will be closely monitored as society moves further away from the COVID-19 pandemic — essentially to determine whether post-COVID-related health problems in this group persist or increase more compared to the other WTC responder of the program patients†
“We are doing further studies to see if the reason for persistent symptoms related to the infection is due to ongoing inflammation in the brain and lungs,” adds Dr. Luft, citing an example of their follow-up clinical study of this particular population of responders.
Elizabeth Lhuillier et al, The Impact of World Trade Center Related Medical Conditions on the Severity of COVID-19 Disease and the Long-Term Sequelae, International Journal of Environmental Research and Public Health (2022). DOI: 10.3390/ijerph19126963
Stony Brook University
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