Differences in the incidence and clinical outcomes of SARS-CoV-2 infection between Italian and non-Italian nationals using routine data.

OBJECTIVES: This study was to compare the incidence and clinical outcomes of SARS-CoV-2 infection between Italian and non-Italian nationals. STUDY DESIGN: We retrospectively analysed data from the COVID-19 Italian integrated surveillance system (14 September 2020 to 17 October 2021). METHODS: We used multivariable Cox proportional hazards models to estimate the hazard ratio (HR) of infection and, among cases, the HRs of death, hospitalisation and subsequent admission to intensive care unit in non-Italian nationals relative to Italian nationals. Estimates were adjusted for differences in sociodemographic characteristics and in the week and region of diagnosis. RESULTS: Of 4,111,067 notified cases, 336,265 (8.2%) were non-Italian nationals. Compared with Italian nationals, non-Italians showed a lower incidence of SARS-CoV-2 infection (HR = 0.81, 95% confidence interval [CI]: 0.80-0.81). However, once diagnosed, they were more likely to be hospitalised (HR = 1.90, 95% CI: 1.87-1.92) and then admitted to intensive care unit (HR = 1.08, 95% CI: 1.04-1.13), with differences larger in those coming from countries with a lower human development index. Compared with Italian cases, an increased rate of death was observed in non-Italian cases from low-human development index countries (HR = 1.41, 95% CI: 1.23-1.62). The HRs of SARS-CoV-2 infection and severe outcomes slightly increased after the start of the vaccination campaign. CONCLUSIONS: Underdiagnosis and delayed diagnosis in non-Italian nationals could explain their lower incidence compared with Italians and, among cases, their higher probability to present clinical conditions leading to worse outcomes. Facilitating early access to vaccination, diagnosis and treatment would improve the control of SARS-CoV-2 transmission and health outcomes in this vulnerable group.

Airborne mineral components and trace metals in Paris region: spatial and temporal variability.

A variety of mineral components (Al, Fe) and trace metals (V, Cr, Mn, Ni, Cu, Zn, Cd, Pb) were simultaneously measured in PM2.5 and PM10 fractions at three different locations (traffic, urban, and suburban) in the Greater Paris Area (GPA) on a daily basis throughout a year. Mineral species and trace metal levels measured in both fractions are in agreement with those reported in the literature and below the thresholds defined by the European guidelines for toxic metals (Cd, Ni, Pb). Size distribution between PM2.5 and PM10 fractions revealed that mineral components prevail in the coarse mode, while trace metals are mainly confined in the fine one. Enrichment factor analysis, statistical analysis, and seasonal variability suggest that elements such as Mn, Cr, Zn, Fe, and Cu are attributed to traffic, V and Ni to oil combustion while Cd and Pb to industrial activities with regional origin. Meteorological parameters such as rain, boundary layer height (BLH), and air mass origin were found to significantly influence element concentrations. Periods with high frequency of northern and eastern air masses (from high populated and industrialized areas) are characterized by high metal concentrations. Finally, inner city and traffic emissions were also evaluated in PM2.5 fraction. Significant contributions (>50 %) were measured in the traffic site for Mn, Fe, Cr, Zn, and Cu, confirming that vehicle emissions contribute significantly to their levels, while in the urban site, the lower contributions (18 to 33 %) for all measured metals highlight the influence of regional sources on their levels.