Long-term exposure to air pollution and risk of SARS-CoV-2 infection and COVID-19 hospitalization or death: Danish nationwide cohort study

Jiawei Zhang; Youn Hee Lim; Rina So; Jeanette Therming Jørgensen; Laust Hvas Mortensen; George M.  Napolitano; Thomas Cole-Hunter; Steffen Loft; Samir Bhatt; Gerard Hoek; Bert Brunekreef; Rudi Westendorp; Matthias Ketzel; Jørgen Brandt; Theis Lange; Thea Kølsen-Fisher; Zorana Jovanovic Andersen

doi:10.1183/13993003.00280-2023

Long-term exposure to air pollution and risk of SARS-CoV-2 infection and COVID-19 hospitalization or death: Danish nationwide cohort study

Jiawei Zhang, Youn Hee Lim, Rina So, Jeanette Therming Jørgensen, Laust Hvas Mortensen, George M. Napolitano, Thomas Cole-Hunter, Steffen Loft, Samir Bhatt, Gerard Hoek, Bert Brunekreef, Rudi Westendorp, Matthias Ketzel, Jørgen Brandt, Theis Lange, Thea Kølsen-Fisher, Zorana Jovanovic Andersen

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

19 Citationer (Scopus)

Abstract

Background Early ecological studies have suggested links between air pollution and risk of coronavirus disease 2019 (COVID-19), but evidence from individual-level cohort studies is still sparse. We examined whether long-Term exposure to air pollution is associated with risk of COVID-19 and who is most susceptible. Methods We followed 3 721 810 Danish residents aged <30 years on 1 March 2020 in the National COVID-19 Surveillance System until the date of first positive test (incidence), COVID-19 hospitalisation or death until 26 April 2021. We estimated residential annual mean particulate matter with diameter >2.5 μm (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone (O3) in 2019 by the Danish DEHM/UBM model, and used Cox proportional hazards regression models to estimate the associations of air pollutants with COVID-19 outcomes, adjusting for age, sex, individual-and area-level socioeconomic status, and population density. Results 138 742 individuals were infected, 11 270 were hospitalised and 2557 died from COVID-19 during 14 months. We detected associations of PM2.5 (per 0.53 μg m?3) and NO2 (per 3.59 μg m?3) with COVID-19 incidence (hazard ratio (HR) 1.10 (95% CI 1.05-1.14) and HR 1.18 (95% CI 1.14-1.23), respectively), hospitalisations (HR 1.09 (95% CI 1.01-1.17) and HR 1.19 (95% CI 1.12-1.27), respectively) and death (HR 1.23 (95% CI 1.04-1.44) and HR 1.18 (95% CI 1.03-1.34), respectively), which were strongest in the lowest socioeconomic groups and among patients with chronic respiratory, cardiometabolic and neurodegenerative diseases. We found positive associations with BC and negative associations with O3. Conclusion Long-Term exposure to air pollution may contribute to increased risk of contracting severe acute respiratory syndrome coronavirus 2 infection as well as developing severe COVID-19 disease requiring hospitalisation or resulting in death.

Originalsprog	Engelsk
Tidsskrift	European Respiratory Journal
Vol/bind	62
Nummer	1
ISSN	0903-1936
DOI	https://doi.org/10.1183/13993003.00280-2023
Status	Udgivet - jul. 2023

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10.1183/13993003.00280-2023Licens: CC BY-NC

https://pmc.ncbi.nlm.nih.gov/articles/PMC10288813/pdf/ERJ-00280-2023.pdfLicens: CC BY-NC

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Zhang, J., Lim, Y. H., So, R., Therming Jørgensen, J., Mortensen, L. H., Napolitano, G. M., Cole-Hunter, T., Loft, S., Bhatt, S., Hoek, G., Brunekreef, B., Westendorp, R., Ketzel, M., Brandt, J., Lange, T., Kølsen-Fisher, T., & Andersen, Z. J. (2023). Long-term exposure to air pollution and risk of SARS-CoV-2 infection and COVID-19 hospitalization or death: Danish nationwide cohort study. European Respiratory Journal, 62(1). https://doi.org/10.1183/13993003.00280-2023

@article{0efc04cd42a5416dbc0c5e42dec96d75,

title = "Long-term exposure to air pollution and risk of SARS-CoV-2 infection and COVID-19 hospitalization or death: Danish nationwide cohort study",

abstract = "Background Early ecological studies have suggested links between air pollution and risk of coronavirus disease 2019 (COVID-19), but evidence from individual-level cohort studies is still sparse. We examined whether long-Term exposure to air pollution is associated with risk of COVID-19 and who is most susceptible. Methods We followed 3 721 810 Danish residents aged <30 years on 1 March 2020 in the National COVID-19 Surveillance System until the date of first positive test (incidence), COVID-19 hospitalisation or death until 26 April 2021. We estimated residential annual mean particulate matter with diameter >2.5 μm (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone (O3) in 2019 by the Danish DEHM/UBM model, and used Cox proportional hazards regression models to estimate the associations of air pollutants with COVID-19 outcomes, adjusting for age, sex, individual-and area-level socioeconomic status, and population density. Results 138 742 individuals were infected, 11 270 were hospitalised and 2557 died from COVID-19 during 14 months. We detected associations of PM2.5 (per 0.53 μg m?3) and NO2 (per 3.59 μg m?3) with COVID-19 incidence (hazard ratio (HR) 1.10 (95% CI 1.05-1.14) and HR 1.18 (95% CI 1.14-1.23), respectively), hospitalisations (HR 1.09 (95% CI 1.01-1.17) and HR 1.19 (95% CI 1.12-1.27), respectively) and death (HR 1.23 (95% CI 1.04-1.44) and HR 1.18 (95% CI 1.03-1.34), respectively), which were strongest in the lowest socioeconomic groups and among patients with chronic respiratory, cardiometabolic and neurodegenerative diseases. We found positive associations with BC and negative associations with O3. Conclusion Long-Term exposure to air pollution may contribute to increased risk of contracting severe acute respiratory syndrome coronavirus 2 infection as well as developing severe COVID-19 disease requiring hospitalisation or resulting in death.",

author = "Jiawei Zhang and Lim, {Youn Hee} and Rina So and {Therming J{\o}rgensen}, Jeanette and Mortensen, {Laust Hvas} and Napolitano, {George M.} and Thomas Cole-Hunter and Steffen Loft and Samir Bhatt and Gerard Hoek and Bert Brunekreef and Rudi Westendorp and Matthias Ketzel and J{\o}rgen Brandt and Theis Lange and Thea K{\o}lsen-Fisher and Andersen, {Zorana Jovanovic}",

year = "2023",

month = jul,

doi = "10.1183/13993003.00280-2023",

language = "English",

volume = "62",

journal = "European Respiratory Journal",

issn = "0903-1936",

publisher = "European Respiratory Society",

number = "1",

}

Zhang, J, Lim, YH, So, R, Therming Jørgensen, J, Mortensen, LH, Napolitano, GM, Cole-Hunter, T, Loft, S, Bhatt, S, Hoek, G, Brunekreef, B, Westendorp, R, Ketzel, M , Brandt, J, Lange, T, Kølsen-Fisher, T & Andersen, ZJ 2023, 'Long-term exposure to air pollution and risk of SARS-CoV-2 infection and COVID-19 hospitalization or death: Danish nationwide cohort study', European Respiratory Journal, bind 62, nr. 1. https://doi.org/10.1183/13993003.00280-2023

Long-term exposure to air pollution and risk of SARS-CoV-2 infection and COVID-19 hospitalization or death: Danish nationwide cohort study. / Zhang, Jiawei; Lim, Youn Hee; So, Rina et al.
I: European Respiratory Journal, Bind 62, Nr. 1, 07.2023.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Long-term exposure to air pollution and risk of SARS-CoV-2 infection and COVID-19 hospitalization or death

T2 - Danish nationwide cohort study

AU - Zhang, Jiawei

AU - Lim, Youn Hee

AU - So, Rina

AU - Therming Jørgensen, Jeanette

AU - Mortensen, Laust Hvas

AU - Napolitano, George M.

AU - Cole-Hunter, Thomas

AU - Loft, Steffen

AU - Bhatt, Samir

AU - Hoek, Gerard

AU - Brunekreef, Bert

AU - Westendorp, Rudi

AU - Ketzel, Matthias

AU - Brandt, Jørgen

AU - Lange, Theis

AU - Kølsen-Fisher, Thea

AU - Andersen, Zorana Jovanovic

PY - 2023/7

Y1 - 2023/7

N2 - Background Early ecological studies have suggested links between air pollution and risk of coronavirus disease 2019 (COVID-19), but evidence from individual-level cohort studies is still sparse. We examined whether long-Term exposure to air pollution is associated with risk of COVID-19 and who is most susceptible. Methods We followed 3 721 810 Danish residents aged <30 years on 1 March 2020 in the National COVID-19 Surveillance System until the date of first positive test (incidence), COVID-19 hospitalisation or death until 26 April 2021. We estimated residential annual mean particulate matter with diameter >2.5 μm (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone (O3) in 2019 by the Danish DEHM/UBM model, and used Cox proportional hazards regression models to estimate the associations of air pollutants with COVID-19 outcomes, adjusting for age, sex, individual-and area-level socioeconomic status, and population density. Results 138 742 individuals were infected, 11 270 were hospitalised and 2557 died from COVID-19 during 14 months. We detected associations of PM2.5 (per 0.53 μg m?3) and NO2 (per 3.59 μg m?3) with COVID-19 incidence (hazard ratio (HR) 1.10 (95% CI 1.05-1.14) and HR 1.18 (95% CI 1.14-1.23), respectively), hospitalisations (HR 1.09 (95% CI 1.01-1.17) and HR 1.19 (95% CI 1.12-1.27), respectively) and death (HR 1.23 (95% CI 1.04-1.44) and HR 1.18 (95% CI 1.03-1.34), respectively), which were strongest in the lowest socioeconomic groups and among patients with chronic respiratory, cardiometabolic and neurodegenerative diseases. We found positive associations with BC and negative associations with O3. Conclusion Long-Term exposure to air pollution may contribute to increased risk of contracting severe acute respiratory syndrome coronavirus 2 infection as well as developing severe COVID-19 disease requiring hospitalisation or resulting in death.

AB - Background Early ecological studies have suggested links between air pollution and risk of coronavirus disease 2019 (COVID-19), but evidence from individual-level cohort studies is still sparse. We examined whether long-Term exposure to air pollution is associated with risk of COVID-19 and who is most susceptible. Methods We followed 3 721 810 Danish residents aged <30 years on 1 March 2020 in the National COVID-19 Surveillance System until the date of first positive test (incidence), COVID-19 hospitalisation or death until 26 April 2021. We estimated residential annual mean particulate matter with diameter >2.5 μm (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone (O3) in 2019 by the Danish DEHM/UBM model, and used Cox proportional hazards regression models to estimate the associations of air pollutants with COVID-19 outcomes, adjusting for age, sex, individual-and area-level socioeconomic status, and population density. Results 138 742 individuals were infected, 11 270 were hospitalised and 2557 died from COVID-19 during 14 months. We detected associations of PM2.5 (per 0.53 μg m?3) and NO2 (per 3.59 μg m?3) with COVID-19 incidence (hazard ratio (HR) 1.10 (95% CI 1.05-1.14) and HR 1.18 (95% CI 1.14-1.23), respectively), hospitalisations (HR 1.09 (95% CI 1.01-1.17) and HR 1.19 (95% CI 1.12-1.27), respectively) and death (HR 1.23 (95% CI 1.04-1.44) and HR 1.18 (95% CI 1.03-1.34), respectively), which were strongest in the lowest socioeconomic groups and among patients with chronic respiratory, cardiometabolic and neurodegenerative diseases. We found positive associations with BC and negative associations with O3. Conclusion Long-Term exposure to air pollution may contribute to increased risk of contracting severe acute respiratory syndrome coronavirus 2 infection as well as developing severe COVID-19 disease requiring hospitalisation or resulting in death.

UR - http://www.scopus.com/inward/record.url?scp=85164260387&partnerID=8YFLogxK

U2 - 10.1183/13993003.00280-2023

DO - 10.1183/13993003.00280-2023

M3 - Journal article

C2 - 37343976

SN - 0903-1936

VL - 62

JO - European Respiratory Journal

JF - European Respiratory Journal

IS - 1

ER -

Long-term exposure to air pollution and risk of SARS-CoV-2 infection and COVID-19 hospitalization or death: Danish nationwide cohort study

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