Original Article

Air pollution and the pandemic: Long-term PM_2.5 exposure and disease severity in COVID-19 patients

Corresponding Author

Angelico Mendy

[email protected]

orcid.org/0000-0002-8227-6830

Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA

Correspondence

Angelico Mendy, Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, 160 Panzeca Way, Room 335, Cincinnati, OH 45267, USA.

Email: [email protected]

Contribution: Conceptualization (equal), Data curation (equal), Formal analysis (equal), Funding acquisition (equal), Investigation (equal), Methodology (equal), Supervision (equal), Validation (equal), Visualization (equal), Writing - original draft (equal), Writing - review & editing (equal)

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Xiao Wu,

Xiao Wu

Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA

Contribution: Conceptualization (equal), Data curation (equal), Formal analysis (equal), Methodology (equal), Resources (equal), Writing - original draft (equal)

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Jason L. Keller,

Jason L. Keller

Center for Health Informatics, Department of Biomedical Informatics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA

Contribution: Conceptualization (equal), Data curation (equal), Formal analysis (equal), Methodology (equal), Validation (equal), Writing - original draft (equal)

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Cecily S. Fassler,

Cecily S. Fassler

orcid.org/0000-0003-2067-7687

Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA

Contribution: Formal analysis (equal), Methodology (equal), Writing - original draft (equal), Writing - review & editing (equal)

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Senu Apewokin,

Senu Apewokin

Division of Infectious Diseases, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA

Contribution: Conceptualization (supporting), Formal analysis (supporting), Methodology (supporting), Validation (equal), Writing - original draft (equal), Writing - review & editing (equal)

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Tesfaye B. Mersha,

Tesfaye B. Mersha

Division of Asthma Research, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA

Contribution: Conceptualization (equal), Data curation (equal), Formal analysis (equal), Methodology (equal), Writing - original draft (equal), Writing - review & editing (equal)

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Changchun Xie,

Changchun Xie

Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA

Contribution: Conceptualization (equal), Formal analysis (equal), Methodology (equal), Writing - original draft (equal), Writing - review & editing (equal)

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Susan M. Pinney,

Susan M. Pinney

Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA

Contribution: Funding acquisition (equal), Methodology (equal), Resources (equal), Writing - original draft (equal), Writing - review & editing (equal)

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Angelico Mendy,

Corresponding Author

Angelico Mendy

[email protected]

orcid.org/0000-0002-8227-6830

Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA

Correspondence

Angelico Mendy, Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, 160 Panzeca Way, Room 335, Cincinnati, OH 45267, USA.

Email: [email protected]

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Xiao Wu,

Xiao Wu

Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA

Contribution: Conceptualization (equal), Data curation (equal), Formal analysis (equal), Methodology (equal), Resources (equal), Writing - original draft (equal)

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Jason L. Keller,

Jason L. Keller

Center for Health Informatics, Department of Biomedical Informatics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA

Contribution: Conceptualization (equal), Data curation (equal), Formal analysis (equal), Methodology (equal), Validation (equal), Writing - original draft (equal)

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Cecily S. Fassler,

Cecily S. Fassler

orcid.org/0000-0003-2067-7687

Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA

Contribution: Formal analysis (equal), Methodology (equal), Writing - original draft (equal), Writing - review & editing (equal)

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Senu Apewokin,

Senu Apewokin

Division of Infectious Diseases, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA

Contribution: Conceptualization (supporting), Formal analysis (supporting), Methodology (supporting), Validation (equal), Writing - original draft (equal), Writing - review & editing (equal)

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Tesfaye B. Mersha,

Tesfaye B. Mersha

Division of Asthma Research, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA

Contribution: Conceptualization (equal), Data curation (equal), Formal analysis (equal), Methodology (equal), Writing - original draft (equal), Writing - review & editing (equal)

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Changchun Xie,

Changchun Xie

Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA

Contribution: Conceptualization (equal), Formal analysis (equal), Methodology (equal), Writing - original draft (equal), Writing - review & editing (equal)

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Susan M. Pinney,

Susan M. Pinney

Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA

Contribution: Funding acquisition (equal), Methodology (equal), Resources (equal), Writing - original draft (equal), Writing - review & editing (equal)

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First published: 30 August 2021

https://doi.org/10.1111/resp.14140

Citations: 26

Associate Editor: Alexander Larcombe and Senior Editor: Paul King

Funding information: National Institute of Environmental Health Sciences, Grant/Award Numbers: P30 ES006096, T32ES010957; National Center for Advancing Translational Sciences of the National Institute of Health (NIH), Grant/Award Number: 5UL1TR001425-03; US NIH, Grant/Award Numbers: R01 HL132344, K08CA237735

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Abstract

Background and objective

Ecological studies have suggested an association between exposure to particulate matter ≤2.5 μm (PM_2.5) 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 PM_2.5 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) PM_2.5 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 PM_2.5, 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) PM_2.5 was 10.48 (1.12) μg/m³. In adjusted analysis, 1 μg/m³ increase in 10-year annual average PM_2.5 was associated with 18% higher hospitalization (OR: 1.18, 95% CI: 1.11–1.26). Likewise, 1 μg/m³ increase in PM_2.5 estimated for the year 2018 was associated with 14% higher hospitalization (OR: 1.14, 95% CI: 1.08–1.21).

Conclusion

Long-term PM_2.5 exposure is associated with increased hospitalization in COVID-19. Therefore, more stringent COVID-19 prevention measures may be needed in areas with higher PM_2.5 exposure to reduce the disease morbidity and healthcare burden.

CONFLICT OF INTEREST

None declared.

Supporting Information

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Volume26, Issue12

December 2021

Pages 1181-1187

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Air pollution and the pandemic: Long-term PM_2.5 exposure and disease severity in COVID-19 patients

Abstract

Background and objective

Methods

Results

Conclusion

CONFLICT OF INTEREST

Supporting Information

REFERENCES

Citing Literature

References

Information

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

Abstract

Background and objective

Methods

Results

Conclusion

CONFLICT OF INTEREST

Supporting Information

REFERENCES

Citing Literature

References

Related

Information

Air pollution and the pandemic: Long-term PM_2.5 exposure and disease severity in COVID-19 patients