Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166 China.
Nanjing Public Health Medical Center, the Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210003 China.
J Infect. 2022 May;84(5):684-691. doi: 10.1016/j.jinf.2022.01.037. Epub 2022 Feb 1.
Previous studies have suggested a relationship between outdoor air pollution and the risk of coronavirus disease 2019 (COVID-19). However, there is a lack of data related to the severity of disease, especially in China. This study aimed to explore the association between short-term exposure to outdoor particulate matter (PM) and the risk of severe COVID-19.
We recruited patients diagnosed with COVID-19 during a recent large-scale outbreak in eastern China caused by the Delta variant. We collected data on meteorological factors and ambient air pollution during the same time period and in the same region where the cases occurred and applied a generalized additive model (GAM) to analyze the effects of short-term ambient PM exposure on the risk of severe COVID-19.
A total of 476 adult patients with confirmed COVID-19 were recruited, of which 42 (8.82%) had severe disease. With a unit increase in PM, the risk of severe COVID-19 increased by 81.70% (95% confidence interval [CI]: 35.45, 143.76) at a lag of 0-7 days, 86.04% (95% CI: 38.71, 149.53) at a lag of 0-14 days, 76.26% (95% CI: 33.68, 132.42) at a lag of 0-21 days, and 72.15% (95% CI: 21.02, 144.88) at a lag of 0-28 days. The associations remained significant at lags of 0-7 days, 0-14 days, and 0-28 days in the multipollutant models. With a unit increase in PM, the risk of severe COVID-19 increased by 299.08% (95% CI: 92.94, 725.46) at a lag of 0-7 days, 289.23% (95% CI: 85.62, 716.20) at a lag of 0-14 days, 234.34% (95% CI: 63.81, 582.40) at a lag of 0-21 days, and 204.04% (95% CI: 39.28, 563.71) at a lag of 0-28 days. The associations were still significant at lags of 0-7 days, 0-14 days, and 0-28 days in the multipollutant models.
Our results indicated that short-term exposure to outdoor PM was positively related to the risk of severe COVID-19, and that reducing air pollution may contribute to the control of COVID-19.
先前的研究表明，室外空气污染与 2019 年冠状病毒病（COVID-19）的风险之间存在关联。然而，与疾病严重程度相关的数据却很缺乏，尤其是在中国。本研究旨在探讨短期暴露于户外颗粒物（PM）与 COVID-19 重症风险之间的关系。
我们招募了在中国东部由德尔塔变异引起的最近一次大规模疫情中确诊的 COVID-19 患者。我们收集了同一时期同一地区病例发生时的气象因素和环境空气污染数据，并应用广义加性模型（GAM）分析了短期环境 PM 暴露对 COVID-19 重症风险的影响。
共纳入 476 例确诊 COVID-19 的成年患者，其中 42 例（8.82%）为重症。在滞后 0-7 天、0-14 天、0-21 天和 0-28 天时，PM 每增加一个单位，COVID-19 重症的风险分别增加 81.70%（95%置信区间 [CI]：35.45，143.76）、86.04%（95% CI：38.71，149.53）、76.26%（95% CI：33.68，132.42）和 72.15%（95% CI：21.02，144.88）。在多污染物模型中，滞后 0-7 天、0-14 天和 0-28 天时的关联仍然显著。在滞后 0-7 天时，PM 每增加一个单位，COVID-19 重症的风险增加 299.08%（95% CI：92.94，725.46），在滞后 0-14 天时，风险增加 289.23%（95% CI：85.62，716.20），在滞后 0-21 天时，风险增加 234.34%（95% CI：63.81，582.40），在滞后 0-28 天时，风险增加 204.04%（95% CI：39.28，563.71）。在多污染物模型中，滞后 0-7 天、0-14 天和 0-28 天时的关联仍然显著。
我们的结果表明，短期暴露于户外 PM 与 COVID-19 重症风险呈正相关，减少空气污染可能有助于控制 COVID-19。
