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. 2021 Mar:178:106313.
doi: 10.1016/j.rmed.2021.106313. Epub 2021 Jan 26.

Long-term exposure to fine particulate matter and hospitalization in COVID-19 patients

Angelico Mendy  1 , Xiao Wu  2 , Jason L Keller  3 , Cecily S Fassler  4 , Senu Apewokin  5 , Tesfaye B Mersha  6 , Changchun Xie  7 , Susan M Pinney  4
Affiliations

Long-term exposure to fine particulate matter and hospitalization in COVID-19 patients

Angelico Mendy et al. Respir Med. 2021 Mar.

Abstract

Background: Ecological evidence suggests that exposure to air pollution affects coronavirus disease 2019 (COVID-19) outcomes. However, no individual-level study has confirmed the association to date.

Methods: We identified COVID-19 patients diagnosed at the University of Cincinnati hospitals and clinics and estimated particulate matter ≤2.5 μm (PM2.5) exposure over a 10-year period (2008-2017) at their residential zip codes. We used logistic regression to evaluate the association between PM2.5 exposure and hospitalizations for COVID-19, adjusting for socioeconomic characteristics and comorbidities.

Results: Among the 1128 patients included in our study, the mean (standard deviation) PM2.5 was 11.34 (0.70) μg/m3 for the 10-year average exposure and 13.83 (1.03) μg/m3 for the 10-year maximal exposures. The association between long-term PM2.5 exposure and hospitalization for COVID-19 was contingent upon having pre-existing asthma or chronic obstructive pulmonary (COPD) (Pinteraction = 0.030 for average PM2.5 and Pinteraction = 0.001 for maximal PM2.5). In COVID-19 patients with asthma or COPD, the odds of hospitalization were 62% higher with 1 μg/m3 increment in 10-year average PM2.5 (odds ratio [OR]: 1.62, 95% confidence interval [CI]: 1.00-2.64) and 65% higher with 1 μg/m3 increase in 10-year maximal PM2.5 levels (OR: 1.65, 95% CI: 1.16-2.35). However, among COVID-19 patients without asthma or COPD, PM2.5 exposure was not associated with higher hospitalizations (OR: 0.84, 95% CI: 0.65-1.09 for average PM2.5 and OR: 0.78, 95% CI: 0.65-0.95 for maximal PM2.5).

Conclusions: Long-term exposure to PM2.5 is associated with higher odds of hospitalization in COVID-19 patients with pre-existing asthma or COPD.

Keywords: Air pollution; COVID-19; Fine particulate matter; PM(2.5); SARS-CoV-2.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

Fig. 1
Fig. 1
Odds ratios (OR) and 95% confidence interval (CI) for association of 1 μg/m3 increase in average and maximal PM2.5 exposure with COVID-19 hospitalization. In Panels A and B, OR (95% CI) reported for 1 μg/m3 increase in average (panel A) and maximal (panel B) PM2.5 in all participants and in participants with and without respiratory disease. In Panels C and D, OR (95% CI) reported for 1 μg/m3 increase in average (panel C) and maximal (panel D) PM2.5 in participants with and without asthma or with and without COPD. PM2.5 association with COVID-19 hospitalization was different by respiratory disease for average PM2.5 (panel A) and for maximal PM2.5 (panels B and D). Models adjusted for age, sex, race/ethnicity, median household income, cigarette smoking, and comorbidities (obesity, diabetes, asthma, COPD, cardiovascular disease, chronic kidney disease, and neoplasm or history of neoplasm). *P < 0.05 **P < 0.01.
See this image and copyright information in PMC

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