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Ambient air pollution and low temperature associated with case fatality of COVID-19: A nationwide retrospective cohort study in China

The evidence for the effects of environmental factors on COVID-19 case fatality remains controversial, and it is crucial to understand the role of preventable environmental factors in driving COVID-19 fatality. We thus conducted a nationwide cohort study to estimate the effects of environmental fact...

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Autores principales: Tian, Fei, Liu, Xiaobo, Chao, Qingchen, Qian, Zhengmin (Min), Zhang, Siqi, Qi, Li, Niu, Yanlin, Arnold, Lauren D., Zhang, Shiyu, Li, Huan, Lin, Hualiang, Liu, Qiyong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8226106/
https://www.ncbi.nlm.nih.gov/pubmed/34189495
http://dx.doi.org/10.1016/j.xinn.2021.100139
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author Tian, Fei
Liu, Xiaobo
Chao, Qingchen
Qian, Zhengmin (Min)
Zhang, Siqi
Qi, Li
Niu, Yanlin
Arnold, Lauren D.
Zhang, Shiyu
Li, Huan
Lin, Hualiang
Liu, Qiyong
author_facet Tian, Fei
Liu, Xiaobo
Chao, Qingchen
Qian, Zhengmin (Min)
Zhang, Siqi
Qi, Li
Niu, Yanlin
Arnold, Lauren D.
Zhang, Shiyu
Li, Huan
Lin, Hualiang
Liu, Qiyong
author_sort Tian, Fei
collection PubMed
description The evidence for the effects of environmental factors on COVID-19 case fatality remains controversial, and it is crucial to understand the role of preventable environmental factors in driving COVID-19 fatality. We thus conducted a nationwide cohort study to estimate the effects of environmental factors (temperature, particulate matter [PM(2.5), PM(10)], sulfur dioxide [SO(2)], nitrogen dioxide [NO(2)], and ozone [O(3)]) on COVID-19 case fatality. A total of 71,808 confirmed COVID-19 cases were identified and followed up for their vital status through April 25, 2020. Exposures to ambient air pollution and temperature were estimated by linking the city- and county-level monitoring data to the residential community of each participant. For each participant, two windows were defined: the period from symptom onset to diagnosis (exposure window I) and the period from diagnosis date to date of death/recovery or end of the study period (exposure window II). Cox proportional hazards models were used to estimate the associations between these environmental factors and COVID-19 case fatality. COVID-19 case fatality increased in association with environmental factors for the two exposure windows. For example, each 10 μg/m(3) increase in PM(2.5), PM(10), O(3), and NO(2) in window I was associated with a hazard ratio of 1.11 (95% CI 1.09, 1.13), 1.10 (95% CI 1.08, 1.13), 1.09 (95 CI 1.03, 1.14), and 1.27 (95% CI 1.19, 1.35) for COVID-19 fatality, respectively. A significant effect was also observed for low temperature, with a hazard ratio of 1.03 (95% CI 1.01, 1.04) for COVID-19 case fatality per 1°C decrease. Subgroup analysis indicated that these effects were stronger in the elderly, as well as in those with mild symptoms and living in Wuhan or Hubei. Overall, the sensitivity analyses also yielded consistent estimates. Short-term exposure to ambient air pollution and low temperature during the illness would play a nonnegligible part in causing case fatality due to COVID-19. Reduced exposures to high concentrations of PM(2.5), PM(10), O(3), SO(2), and NO(2) and low temperature would help improve the prognosis and reduce public health burden.
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spelling pubmed-82261062021-06-25 Ambient air pollution and low temperature associated with case fatality of COVID-19: A nationwide retrospective cohort study in China Tian, Fei Liu, Xiaobo Chao, Qingchen Qian, Zhengmin (Min) Zhang, Siqi Qi, Li Niu, Yanlin Arnold, Lauren D. Zhang, Shiyu Li, Huan Lin, Hualiang Liu, Qiyong Innovation (Camb) Report The evidence for the effects of environmental factors on COVID-19 case fatality remains controversial, and it is crucial to understand the role of preventable environmental factors in driving COVID-19 fatality. We thus conducted a nationwide cohort study to estimate the effects of environmental factors (temperature, particulate matter [PM(2.5), PM(10)], sulfur dioxide [SO(2)], nitrogen dioxide [NO(2)], and ozone [O(3)]) on COVID-19 case fatality. A total of 71,808 confirmed COVID-19 cases were identified and followed up for their vital status through April 25, 2020. Exposures to ambient air pollution and temperature were estimated by linking the city- and county-level monitoring data to the residential community of each participant. For each participant, two windows were defined: the period from symptom onset to diagnosis (exposure window I) and the period from diagnosis date to date of death/recovery or end of the study period (exposure window II). Cox proportional hazards models were used to estimate the associations between these environmental factors and COVID-19 case fatality. COVID-19 case fatality increased in association with environmental factors for the two exposure windows. For example, each 10 μg/m(3) increase in PM(2.5), PM(10), O(3), and NO(2) in window I was associated with a hazard ratio of 1.11 (95% CI 1.09, 1.13), 1.10 (95% CI 1.08, 1.13), 1.09 (95 CI 1.03, 1.14), and 1.27 (95% CI 1.19, 1.35) for COVID-19 fatality, respectively. A significant effect was also observed for low temperature, with a hazard ratio of 1.03 (95% CI 1.01, 1.04) for COVID-19 case fatality per 1°C decrease. Subgroup analysis indicated that these effects were stronger in the elderly, as well as in those with mild symptoms and living in Wuhan or Hubei. Overall, the sensitivity analyses also yielded consistent estimates. Short-term exposure to ambient air pollution and low temperature during the illness would play a nonnegligible part in causing case fatality due to COVID-19. Reduced exposures to high concentrations of PM(2.5), PM(10), O(3), SO(2), and NO(2) and low temperature would help improve the prognosis and reduce public health burden. Elsevier 2021-06-18 /pmc/articles/PMC8226106/ /pubmed/34189495 http://dx.doi.org/10.1016/j.xinn.2021.100139 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Report
Tian, Fei
Liu, Xiaobo
Chao, Qingchen
Qian, Zhengmin (Min)
Zhang, Siqi
Qi, Li
Niu, Yanlin
Arnold, Lauren D.
Zhang, Shiyu
Li, Huan
Lin, Hualiang
Liu, Qiyong
Ambient air pollution and low temperature associated with case fatality of COVID-19: A nationwide retrospective cohort study in China
title Ambient air pollution and low temperature associated with case fatality of COVID-19: A nationwide retrospective cohort study in China
title_full Ambient air pollution and low temperature associated with case fatality of COVID-19: A nationwide retrospective cohort study in China
title_fullStr Ambient air pollution and low temperature associated with case fatality of COVID-19: A nationwide retrospective cohort study in China
title_full_unstemmed Ambient air pollution and low temperature associated with case fatality of COVID-19: A nationwide retrospective cohort study in China
title_short Ambient air pollution and low temperature associated with case fatality of COVID-19: A nationwide retrospective cohort study in China
title_sort ambient air pollution and low temperature associated with case fatality of covid-19: a nationwide retrospective cohort study in china
topic Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8226106/
https://www.ncbi.nlm.nih.gov/pubmed/34189495
http://dx.doi.org/10.1016/j.xinn.2021.100139
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