Exposure to sulfur mustard increases the risk for mortality in patients with COVID-19 infection: A cohort study

Abstract

Objective This study aims to assess the prognosis of inpatients with COVID-19 infection who have a history of sulfur mustard exposure. Methods We started a cohort study in October 2020 and ended in May 2021 on inpatients with COVID-19 infection who had been admitted to university healthcare centers. The analytic sample included 960 inpatients having COVID-19 infection (192 with; and 768 without sulfur mustard exposure). The exposed patients were male war veterans, and the unexposed patients were male individually age-matched people. All patients had a positive RT-PCR test and a positive chest CT for COVID-19. The outcome was death within 28 days of admission, and the predictors were clinical features recorded at patients' bedsides. Results There was a significantly higher prevalence for asthma ( p = 0.026) and pulmonary disease other than asthma ( p < 0.001) in patients with the exposure. Sulfur mustard exposure was associated with increased risk for mortality of COVID-19 [hazard ratio (95% CI) = 1.92 (1.14,3.24), p = 0.013]. Early intubation signified a poor prognosis [hazard = 7.34 (4.65,11.58), p < 0.001]. However, individuals with higher PaO2 [hazard = 0.97 (0.95,0.98), p < 0.001], or people undergoing O2 therapy early upon admission [hazard = 0.58 (0.38,0.89), p = 0.011] showed lower risks for mortality. Individuals with asthma were at higher risk for mortality [hazard = 3.76 (1.69,8.36), p = 0.001]. Conclusion Individuals with COVID-19 infection and sulfur mustard exposure should be considered high-risk patients and that, healthcare settings should be ready to provide critical care for them, including O 2 therapy. They are more likely to have asthma or other pulmonary diseases.

Risk Factors Associated with Severity and Death from COVID-19 in Iran: A Systematic Review and Meta-Analysis Study

“…After deleting duplicates, we identified 2463 studies from four databases and then screened articles by title and full text according to the study's objectives. Finally, 69 studies were included in the meta-analysis (Figure 1), of which 62 studies had assessed risk factors for death from COVID 28–89 ); 13 studies determined risk factors for severity (( 41,50,53–55,65,…”

Grafting-To and From for Multiplexed Chemical-Warfare-Agent Responsive Polymer Brushes

“…Although our previous efforts have focused on electrophilic phosphorus nerve agents, sulfur mustard is still considered a general threat due to its simple method of preparation, broad incapacitating potential, and the continued dearth of an effective antidote to its broad pharmacology. − The previously developed materials have demonstrated an excellent response to phosphorus agents, but showed little to no response to mustard simulants. To build upon our well-developed CWA responsive polymer system, the grafting scheme was carefully modified to enable the incorporation of a variety of activating functional groups, termed multiplexers, with simple chemistry.…”