Higher long-term exposure to air pollution may raise risk for worse COVID-19 outcomes
High long-term exposure to particulate matter was associated with increased risk for mortality and ICU admission among patients hospitalized with COVID-19, researchers reported.
“Risk factors for COVID-19 mortality may extend to environmental exposures, including air pollution,” Anne Bozack, PhD, postdoctoral fellow in the department of environmental health sciences at the University of California, Berkeley, School of Public Health, and colleagues wrote in the American Journal of Respiratory and Critical Care Medicine.
The retrospective analysis evaluated electronic health records of 6,542 patients with confirmed COVID-19 (median age, 65 years; 41% women) who were admitted to seven New York City hospitals from March to August 2020. More than 50% of patients self-identified as a person of color (26% Hispanic; 25% Black). Researchers estimated annual average fine particulate matter (PM2.5), nitrogen dioxide and black carbon concentrations at each patient’s residential address.
The primary outcome was mortality. Secondary outcomes included ICU admission and intubation.
Overall, 31% of patients died, 19% were admitted to the ICU and 16% were intubated.
Researchers observed generally low air pollution exposure levels. Higher long-term air pollution exposure levels were associated with an increased risk for mortality (RR = 1.11 per 1 µg/m3 increase in PM2.5; 95% CI, 1.01-1.21) and ICU admission (RR = 1.13 per 1 µg/m3 increase in PM2.5; 95% CI, 1-1.28) in multivariable models.
Nitrogen dioxide and black carbon exposure were not associated with COVID-19 mortality, ICU admission or intubation.
According to the researchers, the COVID-19 pandemic highlighted the critical impact of environmental, social and structural factors on health disparities, and this analysis suggests that such vulnerability factors extend to long-term air pollution exposure.
“These findings suggest that environmental regulations to further reduce air pollution levels are critically important as governments begin to consider policies to build back the economy,” the researchers wrote.