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. 2021 Dec;26(12):1181-1187.
doi: 10.1111/resp.14140. Epub 2021 Aug 30.

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

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

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

Angelico Mendy et al. Respirology. 2021 Dec.

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.

Keywords: COVID-19 hospitalization; PM2.5 exposure; SARS-CoV-2; air pollution; coronavirus disease.

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Conflict of interest statement

None declared.

Figures

FIGURE 1
FIGURE 1
Mean annual PM2.5 (particulate matter ≤2.5 μm) concentration (μg/m3) from 2009 to 2018
FIGURE 2
FIGURE 2
Distribution of 10‐year annual average particulate matter ≤2.5 μm (PM2.5) (μg/m3) and restricted cubic splines of ORs of admission to hospital. The graph shows an increase in OR for hospitalization with higher PM2.5 levels. Solid lines show the ORs and dashed lines indicate the 95% CIs
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