The DOI matches its Crossref record; 36 of the 36 references it cites were found in a registry or an index.
Urban Air Pollution May Enhance COVID-19 Case-Fatality and Mortality Rates in the United States
Open accessPublished version of a preprint
Abstract
Abstract Background The novel human coronavirus disease 2019 (COVID-19) pandemic has claimed more than 240,000 lives worldwide, causing tremendous public health, social, and economic damages. While the risk factors of COVID-19 are still under investigation, environmental factors, such as urban air pollution, may play an important role in increasing population susceptibility to COVID-19 pathogenesis. Methods We conducted a cross-sectional nationwide study using zero-inflated negative binomial models to estimate the association between long-term (2010-2016) county-level exposures to NO 2 , PM 2.5 and O 3 and county-level COVID-19 case-fatality and mortality rates in the US. We used both single and multipollutant models and controlled for spatial trends and a comprehensive set of potential confounders, including state-level test positive rate, county-level healthcare capacity, phase-of-epidemic, population mobility, sociodemographic, socioeconomic status, behavior risk factors, and meteorological factors. Results 1,027,799 COVID-19 cases and 58,489 deaths were reported in 3,122 US counties from January 22, 2020 to April 29, 2020, with an overall observed case-fatality rate of 5.8%. Spatial variations were observed for both COVID-19 death outcomes and long-term ambient air pollutant levels. County-level average NO 2 concentrations were positively associated with both COVID-19 case-fatality rate and mortality rate in single-, bi-, and tri-pollutant models (p-values<0.05). Per inter-quartile range (IQR) increase in NO 2 (4.6 ppb), COVID-19 case-fatality rate and mortality rate were associated with an increase of 7.1% (95% CI 1.2% to 13.4%) and 11.2% (95% CI 3.4% to 19.5%), respectively. We did not observe significant associations between long-term exposures to PM 2.5 or O 3 and COVID-19 death outcomes (p-values>0.05), although per IQR increase in PM 2.5 (3.4 ug/m 3 ) was marginally associated with 10.8% (95% CI: −1.1% to 24.1%) increase in COVID-19 mortality rate. Discussions and Conclusions Long-term exposure to NO 2 , which largely arises from urban combustion sources such as traffic, may enhance susceptibility to severe COVID-19 outcomes, independent of longterm PM 2.5 and O 3 exposure. The results support targeted public health actions to protect residents from COVID-19 in heavily polluted regions with historically high NO 2 levels. Moreover, continuation of current efforts to lower traffic emissions and ambient air pollution levels may be an important component of reducing population-level risk of COVID-19 deaths.
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Bourdrel, T., Annesi-Maesano, I., Alahmad, B., Maesano, C. N., & Bind, M.-A. (2021) · European Respiratory Review · doi:10.1183/16000617.0242-2020 · Cited by 224
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Metadata
- Authors
- Liang, D., Shi, L., Zhao, J., Liu, P., Sarnat, J. A., Gao, S., Schwartz, J., Liu, Y., Ebelt, S. T., Scovronick, N., & Chang, H. H.
- Venue
- The Innovation
- Publisher
- Elsevier BV
- Published
- 2020-11
- Volume
- 1
- Issue
- 3
- Pages
- 100047
- ISSN
- 2666-6758 (ISSN-L)
- OpenAlex
- W3087321968
- Cited by
- 285
- References
- 36
- FWCI
- 22.55
- Type
- journal article
- Language
- en
- Open access
- gold
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- creativecommons.org/licenses/by-nc-nd/4.0/ (vor)
- Funders
- National Science Foundation (BCS-2027375)
- National Institutes of Health
- National Institute of Environmental Health Sciences (P30ES019776)
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- Liang, D., Shi, L., Zhao, J., Liu, P., Sarnat, J. A., Gao, S., Schwartz, J., Liu, Y., Ebelt, S. T., Scovronick, N., & Chang, H. H. (2020). Urban Air Pollution May Enhance COVID-19 Case-Fatality and Mortality Rates in the United States. The Innovation. https://doi.org/10.1016/j.xinn.2020.100047
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