ArticleEnvironment international2021
Association between urinary per- and poly-fluoroalkyl substances and COVID-19 susceptibility.
Article in Environment international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 41 citations in OpenAlex.
- Association between perfluoroalkyl and polyfluoroalkyl substances and response to the COVID-19 vaccine in a paediatric prospective observational cohort in Arizona.BMJ paediatrics open · 2026Observational
- SARS-CoV-2 Anti-Spike IgG Subclass Titres in a Population with Prior Exposure to Perfluorooctanoic Acid (PFOA).Toxics · 2026Article
- PFOA induced metabolic and immune perturbations in a SARS-2 infection model.bioRxiv : the preprint server for biology · 2026Article
- Article
- Per- and Polyfluoroalkyl Substances (PFAS) Enhance Cholesterol Accumulation and Dysregulate Inflammatory Responses in Macrophages.Cardiovascular toxicology · 2025Article
- County-level associations between drinking water PFAS contamination and COVID-19 mortality in the United States.Journal of exposure science & environmental epidemiology · 2025Article
- Per- and poly-fluoroalkyl substances (PFAS) in circulation in a Canadian population: their association with serum-liver enzyme biomarkers and piloting a novel method to reduce serum-PFAS.Environmental health : a global access science source · 2025Article
- Binary and quaternary mixtures of perfluoroalkyl substances (PFAS) differentially affect the immune response to influenza A virus infection.Journal of immunotoxicology · 2024Article
- Occurrence of COVID-19 and serumGlobal epidemiology · 2024Article
- Emerging contaminants in food matrices: An overview of the occurrence, pathways, impacts and detection techniques of per- and polyfluoroalkyl substances.Toxicology reports · 2024Review
- Serum per- and polyfluoroalkyl substance concentrations and longitudinal change in post-infection and post-vaccination SARS-CoV-2 antibodies.Environmental research · 2023Article
- PFAS Exposures and the Human Metabolome: A Systematic Review of Epidemiological Studies.Current pollution reports · 2023Article
- High Exposure to Perfluoroalkyl Substances and Antibody Responses to SARS-CoV-2 mRNA Vaccine-an Observational Study in Adults from Ronneby, Sweden.Environmental health perspectives · 2023Observational
- Individual blood concentrations of persistent organic pollutants and chemical elements, and COVID-19: A prospective cohort study in Barcelona.Environmental research · 2023Article
- Consideration of pathways for immunotoxicity of per- and polyfluoroalkyl substances (PFAS).Environmental health : a global access science source · 2023Review
- Cross-sectional associations of maternal PFAS exposure on SARS-CoV-2 IgG antibody levels during pregnancy.Environmental research · 2023Article
- Association between fish oil supplements use and serum per- and polyfluoroalkyl substances (PFAS): Results from the National Health and Nutrition Examination Survey.Environmental research · 2022Article
- Exposure to a mixture of per-and polyfluoroalkyl substances modulates pulmonary expression of ACE2 and circulating hormones and cytokines.Toxicology and applied pharmacology · 2022Article
- Antibody response to COVID-19 vaccines among workers with a wide range of exposure to per- and polyfluoroalkyl substances.Environment international · 2022Article
- Factors Modulating COVID-19: A Mechanistic Understanding Based on the Adverse Outcome Pathway Framework.Journal of clinical medicine · 2022Review
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveThe growing impact of the COVID-19 pandemic has heightened the urgency of identifying individuals most at risk of infection. Per- and poly-fluoroalkyl substances (PFASs) are manufactured fluorinated chemicals widely used in many industrial and household products. The objective of this case-control study was to assess the association between PFASs exposure and COVID-19 susceptibility and to elucidate the metabolic dysregulation associated with PFASs exposure in COVID-19 patients.
methodsTotal 160 subjects (80 COVID-19 patients and 80 symptom-free controls) were recruited from Shanxi and Shandong provinces, two regions heavily polluted by PFASs in China. Twelve common PFASs were quantified in both urine and serum. Urine metabolome profiling was performed by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS).
resultsIn unadjusted models, the risk of COVID-19 infection was positively associated with urinary levels of perfluorooctanesulfonic acid (PFOS) (Odds ratio: 2.29 [95% CI: 1.52-3.22]), perfluorooctanoic acid (PFOA) (2.91, [1.95-4.83], and total PFASs (∑ (12) PFASs) (3.31, [2.05-4.65]). After controlling for age, sex, body mass index (BMI), comorbidities, and urine albumin-to-creatinine ratio (UACR), the associations remained statistically significant (Adjusted odds ratio of 1.94 [95% CI: 1.39-2.96] for PFOS, 2.73 [1.71-4.55] for PFOA, and 2.82 [1.97-3.51] for ∑ (12) PFASs). Urine metabolome-PFASs association analysis revealed that 59% of PFASs-associated urinary endogenous metabolites in COVID-19 patients were identified to be produced or largely regulated by mitochondrial function. In addition, the increase of PFASs exposure was associated with the accumulation of key metabolites in kynurenine metabolism, which are involved in immune responses (Combined β coefficient of 0.60 [95% CI: 0.25-0.95, P = 0.001]). Moreover, alternations in PFASs-associated metabolites in mitochondrial and kynurenine metabolism were also correlated with clinical lab biomarkers for mitochondrial function (serum growth/differentiation factor-15) and immune activity (lymphocyte percentage), respectively.
conclusionElevated exposure to PFASs was independently associated with an increased risk of COVID-19 infection. PFASs-associated metabolites were implicated in mitochondrial function and immune activity. Larger studies are needed to confirm our findings and further understand the underlying mechanisms of PFASs exposure in the pathogenesis of SARS-CoV2 infection.
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