Estimating Short- and Long-Term Associations Between Air Quality Index and COVID-19 Transmission: Evidence From 257 Chinese Cities

Objectives: To evaluate the long- and short-term effects of air pollution on COVID-19 transmission simultaneously, especially in high air pollution level countries. Methods: Quasi-Poisson regression was applied to estimate the association between exposure to air pollution and daily new confirmed cases of COVID-19, with mutual adjustment for long- and short-term air quality index (AQI). The independent effects were also estimated and compared. We further assessed the modification effect of within-city migration (WM) index to the associations. Results: We found a significant 1.61% (95%CI: 0.51%, 2.72%) and 0.35% (95%CI: 0.24%, 0.46%) increase in daily confirmed cases per 1 unit increase in long- and short-term AQI. Higher estimates were observed for long-term impact. The stratifying result showed that the association was significant when the within-city migration index was low. A 1.25% (95%CI: 0.0.04%, 2.47%) and 0.41% (95%CI: 0.30%, 0.52%) increase for long- and short-term effect respectively in low within-city migration index was observed. Conclusions: There existed positive associations between long- and short-term AQI and COVID-19 transmission, and within-city migration index modified the association. Our findings will be of strategic significance for long-run COVID-19 control.