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Long-term exposure to fine particulate matter and hospitalization in COVID-19 patients - 27/02/21

Doi : 10.1016/j.rmed.2021.106313 
Angelico Mendy a, , Xiao Wu b, Jason L. Keller c, Cecily S. Fassler a, Senu Apewokin d, Tesfaye B. Mersha e, Changchun Xie f, Susan M. Pinney a
a Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA 
b Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA 
c Center for Health Informatics, Department of Biomedical Informatics, College of Medicine, University of Cincinnati, OH, USA 
d Division of Infectious Diseases, Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA 
e Division of Asthma Research, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA 
f Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA 

Corresponding author. Division of Epidemiology, Department of Environmental & Public Health Sciences, The University of Cincinnati College of Medicine, 160 Panzeca Way, Room 335, Cincinnati, OH, 45267.Division of EpidemiologyDepartment of Environmental & Public Health SciencesThe University of Cincinnati College of Medicine160 Panzeca Way, Room 335CincinnatiOH45267

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Abstract

Background

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.

Methods

We identified COVID-19 patients diagnosed at the University of Cincinnati hospitals and clinics and estimated particulate matter ≤2.5 μm (PM2.5) exposure over a 10-year period (2008–2017) at their residential zip codes. We used logistic regression to evaluate the association between PM2.5 exposure and hospitalizations for COVID-19, adjusting for socioeconomic characteristics and comorbidities.

Results

Among the 1128 patients included in our study, the mean (standard deviation) PM2.5 was 11.34 (0.70) μg/m3 for the 10-year average exposure and 13.83 (1.03) μg/m3 for the 10-year maximal exposures. The association between long-term PM2.5 exposure and hospitalization for COVID-19 was contingent upon having pre-existing asthma or chronic obstructive pulmonary (COPD) (Pinteraction = 0.030 for average PM2.5 and Pinteraction = 0.001 for maximal PM2.5). In COVID-19 patients with asthma or COPD, the odds of hospitalization were 62% higher with 1 μg/m3 increment in 10-year average PM2.5 (odds ratio [OR]: 1.62, 95% confidence interval [CI]: 1.00–2.64) and 65% higher with 1 μg/m3 increase in 10-year maximal PM2.5 levels (OR: 1.65, 95% CI: 1.16–2.35). However, among COVID-19 patients without asthma or COPD, PM2.5 exposure was not associated with higher hospitalizations (OR: 0.84, 95% CI: 0.65–1.09 for average PM2.5 and OR: 0.78, 95% CI: 0.65–0.95 for maximal PM2.5).

Conclusions

Long-term exposure to PM2.5 is associated with higher odds of hospitalization in COVID-19 patients with pre-existing asthma or COPD.

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Highlights

Association between PM2.5 exposure and COVID-19 hospitalization depended on pre-existing respiratory diseases.
PM2.5 was associated with higher odds of COVID-19 hospitalization in patients with asthma or COPD.
PM2.5 was not associated with higher odds of COVID-19 hospitalization in patients without asthma or COPD.

Le texte complet de cet article est disponible en PDF.

Keywords : Air pollution, Fine particulate matter, PM2.5, COVID-19, SARS-CoV-2


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Vol 178

Article 106313- mars 2021 Retour au numéro
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