The widespread presence of estrogens in aquatic environments represents a One Health concern, as it simultaneously threatens environmental integrity, wildlife health, and human well-being. These compounds, widely used in human and veterinary medicine, are excreted in partially or unmetabolized forms and persist in the environment due to the inefficiency of conventional water treatment systems in removing them. This systematic review provides a global overview of the occurrence of estrogens in water resources. We synthesized data on study characteristics, estrogen compounds detected, their concentrations, types of water bodies, and geographic locations. In total, 39 estrogens, including natural, synthetic, and metabolite forms, were reported at concentrations ranging from 0.002 to 10,380,000.0 ng/L across 40 water body types in 59 countries on all continents. The most frequently detected compounds were estrone, estradiol, and ethinylestradiol. Estrogens were predominantly identified in wastewater treatment plant effluents, rivers, lakes, surface waters, and even drinking water sources. These findings underscore the estrogen contamination and its potential to disrupt endocrine functions across species, posing serious implications for ecosystems. Within the One Health framework, this review highlights the urgent need for integrated strategies to improve water quality monitoring, develop advanced treatment technologies, and update regulatory standards to address the multifaceted risks posed by estrogenic contaminants.

Background/Objectives: Cytokine storm in severe COVID-19 is responsible for irreversible tissue damage and death. Soluble mediators from the TNF superfamily, their correlation with clinical outcome, and the use of TNF receptors as a potent predictor for clinical outcome were evaluated. Methods: Severe COVID-19 patients had the levels of soluble mediators from the TNF superfamily quantified and categorized according to the clinical outcome (death versus survival). Statistical modeling was performed to predict clinical outcomes. Results: COVID-19 patients have elevated serum levels from the TNF superfamily. Regardless of sex and age, the sTNFRI levels were observed to be significantly higher in deceased patients from the first weeks following the onset of symptoms. We analyzed hematological parameters and inflammatory markers, and there was a difference between the groups for the following factors: erythrocytes, hemoglobin, hematocrit, leukocytes, neutrophils, band cells, lymphocytes, monocytes, CRP, IL-8, IFN-γ, IL-10, IL-6, IL-4, IL-2, leptin MIF sCD40L, and sTNFRI (p < 0.05). A post hoc analysis showed an inferential capacity over 70% for some hematological markers, CRP, and inflammatory mediators in deceased patients. sTNFRI was strongly associated with death, and the sTNFRI/sTNFRII ratio differed between outcomes (p < 0.001; power above 90%), highlighting the impact of these proteins on clinical results. The final logistic model, including sTNFRI/sTNFRII and CRP, indicated high sensitivity, specificity, accuracy, and an eight-fold higher odds ratio for an unfavorable outcome. Conclusions: The joint use of the sTNFRI/sTNFRII ratio with CRP proves to be a promising tool to assist in the clinical management of patients hospitalized for COVID-19.