Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Eur Respir J. 2023 Jul 7;62(1). doi: 10.1183/13993003.00280-2023. Print 2023 Jul.
Early ecological studies have suggested links between air pollution and risk of coronavirus disease 2019 (COVID-19), but evidence from individual-level cohort studies is still sparse. We examined whether long-term exposure to air pollution is associated with risk of COVID-19 and who is most susceptible.
We followed 3 721 810 Danish residents aged ≥30 years on 1 March 2020 in the National COVID-19 Surveillance System until the date of first positive test (incidence), COVID-19 hospitalisation or death until 26 April 2021. We estimated residential annual mean particulate matter with diameter ≤2.5 μm (PM), nitrogen dioxide (NO), black carbon (BC) and ozone (O) in 2019 by the Danish DEHM/UBM model, and used Cox proportional hazards regression models to estimate the associations of air pollutants with COVID-19 outcomes, adjusting for age, sex, individual- and area-level socioeconomic status, and population density.
138 742 individuals were infected, 11 270 were hospitalised and 2557 died from COVID-19 during 14 months. We detected associations of PM (per 0.53 μg·m) and NO (per 3.59 μg·m) with COVID-19 incidence (hazard ratio (HR) 1.10 (95% CI 1.05-1.14) and HR 1.18 (95% CI 1.14-1.23), respectively), hospitalisations (HR 1.09 (95% CI 1.01-1.17) and HR 1.19 (95% CI 1.12-1.27), respectively) and death (HR 1.23 (95% CI 1.04-1.44) and HR 1.18 (95% CI 1.03-1.34), respectively), which were strongest in the lowest socioeconomic groups and among patients with chronic respiratory, cardiometabolic and neurodegenerative diseases. We found positive associations with BC and negative associations with O.
Long-term exposure to air pollution may contribute to increased risk of contracting severe acute respiratory syndrome coronavirus 2 infection as well as developing severe COVID-19 disease requiring hospitalisation or resulting in death.
早期的生态研究表明，空气污染与 2019 年冠状病毒病（COVID-19）风险之间存在关联，但来自个体水平队列研究的证据仍然很少。我们研究了长期暴露于空气污染是否与 COVID-19 风险相关，以及哪些人更容易受到影响。
我们在丹麦 COVID-19 监测系统中对 2020 年 3 月 1 日年满 30 岁的 3721810 名居民进行了随访，直到首次阳性检测（发病率）、COVID-19 住院或死亡的日期，截止到 2021 年 4 月 26 日。我们使用丹麦 DEHM/UBM 模型估计了 2019 年居住的年平均颗粒物（PM），直径≤2.5μm（PM）、二氧化氮（NO）、黑碳（BC）和臭氧（O），并使用 Cox 比例风险回归模型调整年龄、性别、个体和地区社会经济地位以及人口密度后，估计了空气污染与 COVID-19 结果之间的关联。
在 14 个月的时间里，有 138742 人感染，11270 人住院，2557 人死于 COVID-19。我们发现 PM（每 0.53μg·m）和 NO（每 3.59μg·m）与 COVID-19 发病率（危险比（HR）1.10（95%CI 1.05-1.14）和 HR 1.18（95%CI 1.14-1.23））、住院（HR 1.09（95%CI 1.01-1.17）和 HR 1.19（95%CI 1.12-1.27））和死亡（HR 1.23（95%CI 1.04-1.44）和 HR 1.18（95%CI 1.03-1.34））存在关联，在社会经济地位最低的群体中和患有慢性呼吸道、心血管代谢和神经退行性疾病的患者中，这种关联最强。我们发现 BC 呈正相关，O 呈负相关。
长期暴露于空气污染可能会增加感染严重急性呼吸综合征冠状病毒 2 的风险，并导致需要住院治疗或导致死亡的严重 COVID-19 疾病。
