Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Respir Med. 2021 Mar;178:106313. doi: 10.1016/j.rmed.2021.106313. Epub 2021 Jan 26.
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.
We identified COVID-19 patients diagnosed at the University of Cincinnati hospitals and clinics and estimated particulate matter ≤2.5 μm (PM) exposure over a 10-year period (2008-2017) at their residential zip codes. We used logistic regression to evaluate the association between PM exposure and hospitalizations for COVID-19, adjusting for socioeconomic characteristics and comorbidities.
Among the 1128 patients included in our study, the mean (standard deviation) PM was 11.34 (0.70) μg/m for the 10-year average exposure and 13.83 (1.03) μg/m for the 10-year maximal exposures. The association between long-term PM exposure and hospitalization for COVID-19 was contingent upon having pre-existing asthma or chronic obstructive pulmonary (COPD) (P = 0.030 for average PM and P = 0.001 for maximal PM). In COVID-19 patients with asthma or COPD, the odds of hospitalization were 62% higher with 1 μg/m increment in 10-year average PM (odds ratio [OR]: 1.62, 95% confidence interval [CI]: 1.00-2.64) and 65% higher with 1 μg/m increase in 10-year maximal PM levels (OR: 1.65, 95% CI: 1.16-2.35). However, among COVID-19 patients without asthma or COPD, PM exposure was not associated with higher hospitalizations (OR: 0.84, 95% CI: 0.65-1.09 for average PM and OR: 0.78, 95% CI: 0.65-0.95 for maximal PM).
Long-term exposure to PM is associated with higher odds of hospitalization in COVID-19 patients with pre-existing asthma or COPD.
生态学证据表明，空气污染暴露会影响 2019 年冠状病毒病（COVID-19）的结果。然而，迄今为止，尚无个体水平的研究证实这一关联。
我们确定了在辛辛那提大学医院和诊所诊断出的 COVID-19 患者，并估计了他们居住邮编在过去 10 年（2008-2017 年）内的 PM2.5 暴露量。我们使用逻辑回归来评估 PM 暴露与 COVID-19 住院之间的关联，并调整了社会经济特征和合并症。
在我们的研究中纳入的 1128 例患者中，10 年平均暴露的 PM 平均值（标准差）为 11.34（0.70）μg/m，10 年最大暴露的 PM 平均值（标准差）为 13.83（1.03）μg/m。长期 PM 暴露与 COVID-19 住院之间的关联取决于是否存在既往哮喘或慢性阻塞性肺疾病（COPD）（10 年平均 PM 为 P=0.030，10 年最大 PM 为 P=0.001）。在患有哮喘或 COPD 的 COVID-19 患者中，10 年平均 PM 每增加 1μg/m，住院的几率增加 62%（比值比[OR]：1.62，95%置信区间[CI]：1.00-2.64），10 年最大 PM 水平每增加 1μg/m，住院的几率增加 65%（OR：1.65，95% CI：1.16-2.35）。然而，在没有哮喘或 COPD 的 COVID-19 患者中，PM 暴露与更高的住院率无关（OR：1.00，95% CI：0.65-1.09 平均 PM 和 OR：0.78，95% CI：0.65-0.95 最大 PM）。
长期暴露于 PM 与患有既往哮喘或 COPD 的 COVID-19 患者住院的几率增加有关。
