TY - JOUR

T1 - Long-term exposure to air pollution and COVID-19 severity

T2 - A cohort study in Greater Manchester, United Kingdom

AU - Hyman, Samuel

AU - Zhang, Jiawei

AU - Andersen, Zorana Jovanovic

AU - Cruickshank, Sheena

AU - Møller, Peter

AU - Daras, Konstantinos

AU - Williams, Richard

AU - Topping, David

AU - Lim, Youn-Hee

N1 - Copyright © 2023. Published by Elsevier Ltd.

PY - 2023

Y1 - 2023

N2 - Exposure to outdoor air pollution may affect incidence and severity of coronavirus disease 2019 (COVID-19). In this retrospective cohort based on patient records from the Greater Manchester Care Records, all first COVID-19 cases diagnosed between March 1, 2020 and May 31, 2022 were followed until COVID-19 related hospitalization or death within 28 days. Long-term exposure was estimated using mean annual concentrations of particulate matter with diameter <2.5 μm (PM 2.5), <10 μm (PM 10), nitrogen dioxide (NO 2), ozone (O 3), sulphur dioxide (SO 2) and benzene (C 6H 6) in 2019 using a validated air pollution model developed by the Department for Environment, Food and Rural Affairs (DEFRA). The association of long-term exposure to air pollution with COVID-19 hospitalization and mortality were estimated using multivariate logistic regression models after adjusting for potential individual, temporal and spatial confounders. Significant positive associations were observed between PM 2.5, PM 10, NO 2, SO 2, benzene and COVID-19 hospital admissions with odds ratios (95% Confidence Intervals [CI]) of 1.27 (1.25-1.30), 1.15 (1.13-1.17), 1.12 (1.10-1.14), 1.16 (1.14-1.18), and 1.39 (1.36-1.42), (per interquartile range [IQR]), respectively. Significant positive associations were also observed between PM 2.5, PM 10, SO 2, or benzene and COVID-19 mortality with odds ratios (95% CI) of 1.39 (1.31-1.48), 1.23 (1.17-1.30), 1.18 (1.12-1.24), and 1.62 (1.52-1.72), per IQR, respectively. Individuals who were older, overweight or obese, current smokers, or had underlying comorbidities showed greater associations between all pollutants of interest and hospital admission, compared to the corresponding groups. Long-term exposure to air pollution is associated with developing severe COVID-19 after a positive SARS-CoV-2 infection, resulting in hospitalization or death.

AB - Exposure to outdoor air pollution may affect incidence and severity of coronavirus disease 2019 (COVID-19). In this retrospective cohort based on patient records from the Greater Manchester Care Records, all first COVID-19 cases diagnosed between March 1, 2020 and May 31, 2022 were followed until COVID-19 related hospitalization or death within 28 days. Long-term exposure was estimated using mean annual concentrations of particulate matter with diameter <2.5 μm (PM 2.5), <10 μm (PM 10), nitrogen dioxide (NO 2), ozone (O 3), sulphur dioxide (SO 2) and benzene (C 6H 6) in 2019 using a validated air pollution model developed by the Department for Environment, Food and Rural Affairs (DEFRA). The association of long-term exposure to air pollution with COVID-19 hospitalization and mortality were estimated using multivariate logistic regression models after adjusting for potential individual, temporal and spatial confounders. Significant positive associations were observed between PM 2.5, PM 10, NO 2, SO 2, benzene and COVID-19 hospital admissions with odds ratios (95% Confidence Intervals [CI]) of 1.27 (1.25-1.30), 1.15 (1.13-1.17), 1.12 (1.10-1.14), 1.16 (1.14-1.18), and 1.39 (1.36-1.42), (per interquartile range [IQR]), respectively. Significant positive associations were also observed between PM 2.5, PM 10, SO 2, or benzene and COVID-19 mortality with odds ratios (95% CI) of 1.39 (1.31-1.48), 1.23 (1.17-1.30), 1.18 (1.12-1.24), and 1.62 (1.52-1.72), per IQR, respectively. Individuals who were older, overweight or obese, current smokers, or had underlying comorbidities showed greater associations between all pollutants of interest and hospital admission, compared to the corresponding groups. Long-term exposure to air pollution is associated with developing severe COVID-19 after a positive SARS-CoV-2 infection, resulting in hospitalization or death.

U2 - 10.1016/j.envpol.2023.121594

DO - 10.1016/j.envpol.2023.121594

M3 - Journal article

C2 - 37030601

VL - 327

JO - Environmental Pollution

JF - Environmental Pollution

SN - 0269-7491

M1 - 121594

ER -