1. Short-term exposure to air pollution and hospital admission after COVID-19 in Catalonia: the COVAIR-CAT study.
- Author
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Alari, Anna, Ranzani, Otavio, Olmos, Sergio, Milà, Carles, Rico, Alex, Ballester, Joan, Basagaña, Xavier, Dadvand, Payam, Duarte-Salles, Talita, Nieuwenhuijsen, Mark, Vivanco-Hidalgo, Rosa Maria, and Tonne, Cathryn
- Abstract
Background A growing body of evidence has reported positive associations between long-term exposure to air pollution and poor COVID-19 outcomes. Inconsistent findings have been reported for short-term air pollution, mostly from ecological study designs. Using individual-level data, we studied the association between short-term variation in air pollutants [nitrogen dioxide (NO
2 ), particulate matter with a diameter of <2.5 µm (PM2.5 ) and a diameter of <10 µm (PM10 ) and ozone (O3 )] and hospital admission among individuals diagnosed with COVID-19. Methods The COVAIR-CAT (Air pollution in relation to COVID-19 morbidity and mortality: a large population-based cohort study in Catalonia, Spain) cohort is a large population-based cohort in Catalonia, Spain including 240 902 individuals diagnosed with COVID-19 in the primary care system from 1 March until 31 December 2020. Our outcome was hospitalization within 30 days of COVID-19 diagnosis. We used individual residential address to assign daily air-pollution exposure, estimated using machine-learning methods for spatiotemporal prediction. For each pandemic wave, we fitted Cox proportional-hazards models accounting for non-linear-distributed lagged exposure over the previous 7 days. Results Results differed considerably by pandemic wave. During the second wave, an interquartile-range increase in cumulative weekly exposure to air pollution (lag0_7) was associated with a 12% increase (95% CI: 4% to 20%) in COVID-19 hospitalizations for NO2 , 8% (95% CI: 1% to 16%) for PM2.5 and 9% (95% CI: 3% to 15%) for PM10 . We observed consistent positive associations for same-day (lag0) exposure, whereas lag-specific associations beyond lag0 were generally not statistically significant. Conclusions Our study suggests positive associations between NO2 , PM2.5 and PM10 and hospitalization risk among individuals diagnosed with COVID-19 during the second wave. Cumulative hazard ratios were largely driven by exposure on the same day as hospitalization. [ABSTRACT FROM AUTHOR]- Published
- 2024
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