Severity of COVID-19 at elevated exposure to perfluorinated alkylates
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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 to an association with disease severity. 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 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 unadjusted odds ratio (OR) of 2.19 (95% confidence interval, CI, 1.39-3.46) for increasing severities of the disease. Among those hospitalized, the fully adjusted OR for getting into intensive care or expiring was 5.18 (1.29, 20.72) when based on plasma samples obtained at the time of diagnosis or up to one week before. CONCLUSIONS: Measures of individual exposures to immunotoxic PFASs included short-chain PFBA known to accumulate in the lungs. Elevated plasma-PFBA concentrations were associated with an increased risk of a more severe course of COVID-19. Given the low background exposure levels in this study, the role of exposure to PFASs in COVID-19 needs to be ascertained in populations with elevated exposures.
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PFAS exposure may leave the brain vulnerable to the deleterious impacts of infections, such as COVID-19, through attenuation of the adaptive immune system.
“PFAS exposure may also leave the brain vulnerable to the deleterious impacts of infections, such as COVID-19 (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2), through attenuation of the adaptive immune system”
From A Critical Review and Meta-Analysis of Impacts of Per- and Polyfluorinated Substances on the Brain and Behavior (2022) · cites this paper as Grandjean et al., 2020
The Introduction (page not provided) describes PFAS as immunotoxic and links elevated exposure to lower vaccine-antibody responses. The Conclusions (page not provided) say PFAS exposure may contribute to COVID-19 severity. Neither passage addresses brain vulnerability, and the study does not establish attenuation of adaptive immunity as the mechanism for its COVID-19 finding. (LLM, conf=0.86)
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- Authors
- Grandjean, P., Timmermann, C. A. G., Kruse, M., Nielsen, F., Vinholt, P. J., Boding, L., Heilmann, C., & Mølbak, K.
- Affiliations
- Harvard University (US)
- University of Southern Denmark (DK)
- Odense University Hospital (DK)
- Statens Serum Institut (DK)
- Rigshospitalet (DK)
- Corresponding author
- Grandjean, Philippe
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2020-12-31
- Volume
- 15
- Issue
- 12
- Pages
- e0244815
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC7605584
- OpenAlex
- W3114911023
- Cited by
- 131
- References
- 41
- Citations by year
- 2026: 9 · 2025: 19 · 2024: 22 · 2023: 33 · 2022: 25 · 2021: 23
- FWCI
- 7.51
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- medRxiv (acceptedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, cc-by)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (submittedVersion, cc-by-nc-nd)
- PubMed Central (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Novo Nordisk Fonden (NNF20SA0062871)
- National Institute of Environmental Health Sciences (ES027706)
- Topics
- Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- COVID-19 pandemic, PFAS, perfluorobutanoic acid, disease severity, immunotoxicity, plasma PFAS concentrations, intensive care unit admission, mortality, industrial chemical exposure
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