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Article ; Online: Implications of monsoon season and UVB radiation for COVID-19 in India.

Moozhipurath, Rahul Kalippurayil / Kraft, Lennart

2021 Volume 11, Issue 1, Page(s) 2757

Abstract: India has recorded 142,186 deaths over 36 administrative regions placing India third in the world after the US and Brazil for COVID-19 deaths as of 12 December 2020. Studies indicate that south-west monsoon season plays a role in the dynamics of ... ...

Abstract	India has recorded 142,186 deaths over 36 administrative regions placing India third in the world after the US and Brazil for COVID-19 deaths as of 12 December 2020. Studies indicate that south-west monsoon season plays a role in the dynamics of contagious diseases, which tend to peak post-monsoon season. Recent studies show that vitamin D and its primary source Ultraviolet-B (UVB) radiation may play a protective role in mitigating COVID-19 deaths. However, the combined roles of the monsoon season and UVB radiation in COVID-19 in India remain still unclear. In this observational study, we empirically study the respective roles of monsoon season and UVB radiation, whilst further exploring, whether the monsoon season negatively impacts the protective role of UVB radiation in COVID-19 deaths in India. We use a log-linear Mundlak model to a panel dataset of 36 administrative regions in India from 14 March 2020-19 November 2020 (n = 6751). We use the cumulative COVID-19 deaths as the dependent variable. We isolate the association of monsoon season and UVB radiation as measured by Ultraviolet Index (UVI) from other confounding time-constant and time-varying region-specific factors. After controlling for various confounding factors, we observe that a unit increase in UVI and the monsoon season are separately associated with 1.2 percentage points and 7.5 percentage points decline in growth rates of COVID-19 deaths in the long run. These associations translate into substantial relative changes. For example, a permanent unit increase of UVI is associated with a decrease of growth rates of COVID-19 deaths by 33% (= - 1.2 percentage points) However, the monsoon season, mitigates the protective role of UVI by 77% (0.92 percentage points). Our results indicate a protective role of UVB radiation in mitigating COVID-19 deaths in India. Furthermore, we find evidence that the monsoon season is associated with a significant reduction in the protective role of UVB radiation. Our study outlines the roles of the monsoon season and UVB radiation in COVID-19 in India and supports health-related policy decision making in India.
MeSH term(s)	COVID-19/epidemiology ; COVID-19/virology ; Humans ; India/epidemiology ; Rain ; SARS-CoV-2/isolation & purification ; Seasons ; Ultraviolet Rays
Language	English
Publishing date	2021-02-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-82443-6
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Association of lockdowns with the protective role of ultraviolet-B (UVB) radiation in reducing COVID-19 deaths.

Moozhipurath, Rahul Kalippurayil / Kraft, Lennart

Scientific reports

2021 Volume 11, Issue 1, Page(s) 22851

Abstract: Nations are imposing unprecedented measures at a large scale to contain the spread of the COVID-19 pandemic. While recent studies show that non-pharmaceutical intervention measures such as lockdowns may have mitigated the spread of COVID-19, those ... ...

Abstract	Nations are imposing unprecedented measures at a large scale to contain the spread of the COVID-19 pandemic. While recent studies show that non-pharmaceutical intervention measures such as lockdowns may have mitigated the spread of COVID-19, those measures also lead to substantial economic and social costs, and might limit exposure to ultraviolet-B radiation (UVB). Emerging observational evidence indicates the protective role of UVB and vitamin D in reducing the severity and mortality of COVID-19 deaths. This observational study empirically outlines the protective roles of lockdown and UVB exposure as measured by the ultraviolet index (UVI). Specifically, we examine whether the severity of lockdown is associated with a reduction in the protective role of UVB exposure. We use a log-linear fixed-effects model on a panel dataset of secondary data of 155 countries from 22 January 2020 until 7 October 2020 (n = 29,327). We use the cumulative number of COVID-19 deaths as the dependent variable and isolate the mitigating influence of lockdown severity on the association between UVI and growth rates of COVID-19 deaths from time-constant country-specific and time-varying country-specific potentially confounding factors. After controlling for time-constant and time-varying factors, we find that a unit increase in UVI and lockdown severity are independently associated with - 0.85 percentage points (p.p) and - 4.7 p.p decline in COVID-19 deaths growth rate, indicating their respective protective roles. The change of UVI over time is typically large (e.g., on average, UVI in New York City increases up to 6 units between January until June), indicating that the protective role of UVI might be substantial. However, the widely utilized and least severe lockdown (governmental recommendation to not leave the house) is associated with the mitigation of the protective role of UVI by 81% (0.76 p.p), which indicates a downside risk associated with its widespread use. We find that lockdown severity and UVI are independently associated with a slowdown in the daily growth rates of cumulative COVID-19 deaths. However, we find evidence that an increase in lockdown severity is associated with significant mitigation in the protective role of UVI in reducing COVID-19 deaths. Our results suggest that lockdowns in conjunction with adequate exposure to UVB radiation might have even reduced the number of COVID-19 deaths more strongly than lockdowns alone. For example, we estimate that there would be 11% fewer deaths on average with sufficient UVB exposure during the period people were recommended not to leave their house. Therefore, our study outlines the importance of considering UVB exposure, especially while implementing lockdowns, and could inspire further clinical studies that may support policy decision-making in countries imposing such measures.
MeSH term(s)	COVID-19/mortality ; COVID-19/prevention & control ; Communicable Disease Control/methods ; Humans ; Linear Models ; Models, Statistical ; Pandemics ; Physical Distancing ; Quarantine/psychology ; SARS-CoV-2/pathogenicity ; SARS-CoV-2/radiation effects ; Ultraviolet Rays ; Vitamin D/pharmacology
Chemical Substances	Vitamin D (1406-16-2)
Language	English
Publishing date	2021-11-24
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-01908-w
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Role of Weather Factors in COVID-19 Deaths in Tropical Climate: A Data-Driven Study Focused on Brazil

Kalippurayil Moozhipurath, Rahul

medRxiv

Abstract: Background: Brazil reported 123,780 deaths across 27 administrative regions, making it the second-worst affected country after the US in terms of COVID-19 deaths as of 3 September 2020. Understanding the role of weather factors in COVID-19 in Brazil is ... ...

Abstract	Background: Brazil reported 123,780 deaths across 27 administrative regions, making it the second-worst affected country after the US in terms of COVID-19 deaths as of 3 September 2020. Understanding the role of weather factors in COVID-19 in Brazil is helpful in the long-term mitigation strategy of COVID-19 in other tropical countries because Brazil experienced early large-scale outbreak among tropical countries. Recent COVID-19 studies indicate that relevant weather factors such as temperature, humidity, UV Index (UVI), precipitation, ozone, pollution and cloud cover may influence the spread of COVID-19. Yet, the magnitude and direction of those associations remain inconclusive. Furthermore, there is only limited research exploring the impact of these weather factors in a tropical country like Brazil. In this observational study, we outline the roles of 7 relevant weather factors including temperature, humidity, UVI, precipitation, ozone, pollution (visibility) and cloud cover in COVID-19 deaths in Brazil. Methods: We use a log-linear fixed-effects model to a panel dataset of 27 administrative regions in Brazil across 182 days (n=3882) and analyze the role of relevant weather factors by using daily cumulative COVID-19 deaths in Brazil as the dependent variable. We carry out robustness checks using case-fatality-rate (CFR) as the dependent variable. Findings: We control for all time-fixed and various time-varying region-specific factors confounding factors. We observe a significant negative association of COVID-19 daily deaths growth rate in Brazil with weather factors - UVI, temperature, ozone and cloud cover. Specifically, a unit increase in UVI, maximum temperature, and ozone independently associate with 6.0 percentage points [p<0.001], 1.8 percentage points [p<0.01] and 0.3 percentage points [p<0. 1] decline in COVID-19 deaths growth rate. Further, a unit percentage increase in cloud cover associates with a decline of 0.148 percentage points [p<0.05] in COVID-19 deaths growth rate. Surprisingly, contrary to other studies, we do not find evidence of any association between COVID-19 daily deaths growth rate and humidity, visibility and precipitation. We find our results to be consistent even when we use the CFR as the dependent variable. Interpretation: We find independent protective roles of UVI, temperature, ozone and cloud cover in mitigating COVID-19 deaths, even in a tropical country like Brazil. We observe these results to be consistent across various model specifications, especially for UVI and cloud cover, even after incorporating additional time-varying weather parameters such as dewpoint, pressure, wind speed and wind gust. These results could guide health-related policy decision making in Brazil as well as similar tropical countries.
Keywords	covid19
Language	English
Publishing date	2020-09-14
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2020.09.13.20193532
Database	COVID19

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Article ; Online: Implications of monsoon season and UVB radiation for COVID-19 in India

Rahul Kalippurayil Moozhipurath / Lennart Kraft

Scientific Reports, Vol 11, Iss 1, Pp 1-

2021 Volume 8

Abstract: Abstract India has recorded 142,186 deaths over 36 administrative regions placing India third in the world after the US and Brazil for COVID-19 deaths as of 12 December 2020. Studies indicate that south-west monsoon season plays a role in the dynamics of ...

Abstract	Abstract India has recorded 142,186 deaths over 36 administrative regions placing India third in the world after the US and Brazil for COVID-19 deaths as of 12 December 2020. Studies indicate that south-west monsoon season plays a role in the dynamics of contagious diseases, which tend to peak post-monsoon season. Recent studies show that vitamin D and its primary source Ultraviolet-B (UVB) radiation may play a protective role in mitigating COVID-19 deaths. However, the combined roles of the monsoon season and UVB radiation in COVID-19 in India remain still unclear. In this observational study, we empirically study the respective roles of monsoon season and UVB radiation, whilst further exploring, whether the monsoon season negatively impacts the protective role of UVB radiation in COVID-19 deaths in India. We use a log-linear Mundlak model to a panel dataset of 36 administrative regions in India from 14 March 2020–19 November 2020 (n = 6751). We use the cumulative COVID-19 deaths as the dependent variable. We isolate the association of monsoon season and UVB radiation as measured by Ultraviolet Index (UVI) from other confounding time-constant and time-varying region-specific factors. After controlling for various confounding factors, we observe that a unit increase in UVI and the monsoon season are separately associated with 1.2 percentage points and 7.5 percentage points decline in growth rates of COVID-19 deaths in the long run. These associations translate into substantial relative changes. For example, a permanent unit increase of UVI is associated with a decrease of growth rates of COVID-19 deaths by 33% (= − 1.2 percentage points) However, the monsoon season, mitigates the protective role of UVI by 77% (0.92 percentage points). Our results indicate a protective role of UVB radiation in mitigating COVID-19 deaths in India. Furthermore, we find evidence that the monsoon season is associated with a significant reduction in the protective role of UVB radiation. Our study outlines the roles of the monsoon season and UVB radiation in COVID-19 in India and supports health-related policy decision making in India.
Keywords	Medicine ; R ; Science ; Q
Subject code	571
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Association of lockdowns with the protective role of ultraviolet-B (UVB) radiation in reducing COVID-19 deaths

Rahul Kalippurayil Moozhipurath / Lennart Kraft

Scientific Reports, Vol 11, Iss 1, Pp 1-

2021 Volume 9

Abstract: Abstract Nations are imposing unprecedented measures at a large scale to contain the spread of the COVID-19 pandemic. While recent studies show that non-pharmaceutical intervention measures such as lockdowns may have mitigated the spread of COVID-19, ... ...

Abstract	Abstract Nations are imposing unprecedented measures at a large scale to contain the spread of the COVID-19 pandemic. While recent studies show that non-pharmaceutical intervention measures such as lockdowns may have mitigated the spread of COVID-19, those measures also lead to substantial economic and social costs, and might limit exposure to ultraviolet-B radiation (UVB). Emerging observational evidence indicates the protective role of UVB and vitamin D in reducing the severity and mortality of COVID-19 deaths. This observational study empirically outlines the protective roles of lockdown and UVB exposure as measured by the ultraviolet index (UVI). Specifically, we examine whether the severity of lockdown is associated with a reduction in the protective role of UVB exposure. We use a log-linear fixed-effects model on a panel dataset of secondary data of 155 countries from 22 January 2020 until 7 October 2020 (n = 29,327). We use the cumulative number of COVID-19 deaths as the dependent variable and isolate the mitigating influence of lockdown severity on the association between UVI and growth rates of COVID-19 deaths from time-constant country-specific and time-varying country-specific potentially confounding factors. After controlling for time-constant and time-varying factors, we find that a unit increase in UVI and lockdown severity are independently associated with − 0.85 percentage points (p.p) and − 4.7 p.p decline in COVID-19 deaths growth rate, indicating their respective protective roles. The change of UVI over time is typically large (e.g., on average, UVI in New York City increases up to 6 units between January until June), indicating that the protective role of UVI might be substantial. However, the widely utilized and least severe lockdown (governmental recommendation to not leave the house) is associated with the mitigation of the protective role of UVI by 81% (0.76 p.p), which indicates a downside risk associated with its widespread use. We find that lockdown severity and UVI are independently ...
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Monsoon, Vitamin D, COVID-19

Kalippurayil Moozhipurath, Rahul / Kulkarni, Prashanth

SSRN Electronic Journal ; ISSN 1556-5068

Implications for India (Letter to the Editor)

2020

Keywords	covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
DOI	10.2139/ssrn.3631902
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Monsoon, Vitamin D, COVID-19 : Implications for India (Letter to the Editor)

Kalippurayil Moozhipurath, Rahul Kulkarni Prashanth

Abstract: Background: COVID-19, caused by SARS-CoV-2 virus has caused 11,903 deaths in India as of 17 June 2020 Epidemiological evidence shows that transmission and ... ...

Abstract	Background: COVID-19, caused by SARS-CoV-2 virus has caused 11,903 deaths in India as of 17 June 2020 Epidemiological evidence shows that transmission and peak
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #1466
Database	COVID19

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Article ; Online: Implications of Monsoon Season & UVB Radiation for COVID-19 in India

Kalippurayil Moozhipurath, Rahul / Kraft, Lennart

medRxiv

Abstract: Background: India has recorded 66,333 deaths over 36 administrative regions placing India third in the world after the US and Brazil for COVID-19 deaths as of 2 September 2020. Studies indicate that south-west monsoon season plays a role in the dynamics ... ...

Abstract	Background: India has recorded 66,333 deaths over 36 administrative regions placing India third in the world after the US and Brazil for COVID-19 deaths as of 2 September 2020. Studies indicate that south-west monsoon season plays a role in the dynamics of contagious diseases, which tend to peak post-monsoon season. Recent studies show that vitamin D and its primary source Ultraviolet-B radiation (UVB) may play a protective role in mitigating COVID-19 deaths. However, the combined roles of the monsoon season and UVB in COVID-19 in India are still unclear. In this observational study, we empirically study the respective roles of monsoon season and UVB, whilst further exploring, whether monsoon season negatively impacts the protective role of UVB in COVID-19 deaths in India. Methods: We use a log-linear Mundlak model to a panel dataset of 36 administrative regions in India from 14 March 2020 - 8 August 2020 (n=4005). We use the cumulative COVID-19 deaths as the dependent variable. We isolate the association of monsoon season and UVB as measured by Ultraviolet Index (UVI) from other confounding time-constant and time-varying region-specific factors. Findings: After controlling for various confounding factors, we observe that the monsoon season and a unit increase in UVI are separately associated with 12.8 percentage points and 2.0 percentage points decline in growth rates of COVID-19 deaths in the long run. These associations translate into substantial relative changes. For example, the current monsoon season, that has been going on for two weeks, is associated with a reduction in growth rates of COVID-19 deaths of 59%, whereas a permanent unit increase of UVI is associated with a reduction in growth rates of COVID-19 deaths of 37%. However, the current monsoon season, also reduces the protective role of UVI by 16.3% [0.33 percentage points], plausibly due to lower UVB exposure. Interpretation: We find independent protective roles of both the monsoon season and UVI in mitigating COVID-19 deaths. Furthermore, we find evidence that monsoon season is associated with a significant reduction in the protective role of UVI. The protective role of monsoon season is plausibly due to limited outdoor activities of people. Our study outlines the role of the monsoon season and UVB in COVID-19 in India and supports health-related policy decision making in India.
Keywords	covid19
Language	English
Publishing date	2020-09-25
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2020.09.24.20200576
Database	COVID19

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Article ; Online: Does Lockdown Decrease the Protective Role of ultraviolet-B (UVB) Radiation in Reducing COVID-19 Deaths?

Kalippurayil Moozhipurath, Rahul / Kraft, Lennart

medRxiv

Abstract: Background: Nations are imposing unprecedented measures at large-scale to contain the spread of COVID-19 pandemic. Recent studies indicate that measures such as lockdowns may have slowed down the growth of COVID-19. However, in addition to substantial ... ...

Abstract	Background: Nations are imposing unprecedented measures at large-scale to contain the spread of COVID-19 pandemic. Recent studies indicate that measures such as lockdowns may have slowed down the growth of COVID-19. However, in addition to substantial economic and social costs, these measures also limit the exposure to Ultraviolet-B radiation (UVB). Emerging observational evidence indicate the protective role of UVB and vitamin D in reducing the severity and mortality of COVID-19 deaths. In this observational study, we empirically outline the independent protective roles of lockdown and UVB exposure as measured by ultraviolet index (UVI), whilst also examining whether the severity of lockdown is associated with a reduction in the protective role. Methods. We apply a log-linear fixed-effects model to a panel dataset of 162 countries over a period of 108 days (n=6049). We use the cumulative number of COVID-19 deaths as the dependent variable and isolate the mitigating influence of lockdown severity on the association between UVI and growth-rates of COVID-19 deaths from time-constant country-specific and time-varying country-specific potentially confounding factors. Findings: After controlling for time-constant and time-varying factors, we find that a unit increase in UVI and lockdown severity are independently associated with 17% [-1.8 percentage points] and 77% [-7.9 percentage points] decline in COVID-19 deaths growth rate, indicating their respective protective roles. However, the widely utilized and least severe lockdown (recommendation to not leave the house) already fully mitigates the protective role of UVI by 95% [1.8 percentage points] indicating its downside. Interpretation: We find that lockdown severity and UVI are independently associated with a slowdown in the daily growth rates of cumulative COVID-19 deaths. However, we find consistent evidence that increase in lockdown severity is associated with a significant reduction in the protective role of UVI in reducing COVID-19 deaths. Our results suggest that lockdowns in conjunction with adequate exposure to UVB radiation might have provided even more substantial health benefits, than lockdowns alone. For example, we estimate that there would be 21% fewer deaths on average with sufficient UVB exposure while people were recommended not to leave their house. Therefore, our study outlines the importance of considering UVB exposure, especially while implementing lockdowns and may support policy decision making in countries imposing such measures.
Keywords	covid19
Language	English
Publishing date	2020-07-02
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2020.06.30.20143586
Database	COVID19

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Article ; Online: Evidence Linking Ultraviolet-B (UVB) Radiation to Deaths Attributed to COVID-19

Kalippurayil Moozhipurath, Rahul / Kraft, Lennart / Skiera, Bernd

SSRN Electronic Journal ; ISSN 1556-5068

2020

Keywords	covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
DOI	10.2139/ssrn.3586555
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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