Title: Air pollution and the pandemic: Long-term PM2.5 exposure and disease severity in COVID-19 patients.

Authors: Mendy, Angelico; Wu, Xiao; Keller, Jason L; Fassler, Cecily S; Apewokin, Senu; Mersha, Tesfaye B; Xie, Changchun; Pinney, Susan M

Published In Respirology, (2021 12)

Abstract: BACKGROUND AND OBJECTIVE: Ecological studies have suggested an association between exposure to particulate matter ≤2.5 μm (PM2.5 ) and coronavirus disease 2019 (COVID-19) severity. However, these findings are yet to be validated in individual-level studies. We aimed to determine the association of long-term PM2.5 exposure with hospitalization among individual patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: We estimated the 10-year (2009-2018) PM2.5 exposure at the residential zip code of COVID-19 patients diagnosed at the University of Cincinnati healthcare system between 13 March 2020 and 30 September 2020. Logistic regression was used to determine the odds ratio (OR) and 95% CI for COVID-19 hospitalizations associated with PM2.5 , adjusting for socioeconomic characteristics and comorbidities. RESULTS: Among the 14,783 COVID-19 patients included in our study, 13.6% were hospitalized; the geometric mean (SD) PM2.5 was 10.48 (1.12) μg/m3 . In adjusted analysis, 1 μg/m3 increase in 10-year annual average PM2.5 was associated with 18% higher hospitalization (OR: 1.18, 95% CI: 1.11-1.26). Likewise, 1 μg/m3 increase in PM2.5 estimated for the year 2018 was associated with 14% higher hospitalization (OR: 1.14, 95% CI: 1.08-1.21). CONCLUSION: Long-term PM2.5 exposure is associated with increased hospitalization in COVID-19. Therefore, more stringent COVID-19 prevention measures may be needed in areas with higher PM2.5 exposure to reduce the disease morbidity and healthcare burden.

PubMed ID: 34459069

MeSH Terms: Adult; Aged; Aged, 80 and over; Air Pollutants*/adverse effects; Air Pollutants*/analysis; Air Pollution/adverse effects*; Air Pollution/analysis; COVID-19/epidemiology*; COVID-19/etiology; Environmental Exposure/adverse effects*; Female; Hospitalization/statistics & numerical data*; Humans; Male; Middle Aged; Pandemics; Particulate Matter/adverse effects*; Particulate Matter/analysis; SARS-CoV-2; Severity of Illness Index