Long-term exposure to PM10 above WHO guidelines exacerbates COVID-19 severity and mortality
Por:
Marquès M., Correig E., Ibarretxe D., Anoro E., Antonio Arroyo J., Jericó C., Borrallo R.M., Miret M., Näf S., Pardo A., Perea V., Pérez-Bernalte R., Ramírez-Montesinos R., Royuela M., Soler C., Urquizu-Padilla M., Zamora A., Pedro-Botet J., Masana L., Domingo J.L.
Publicada:
1 ene 2022
Ahead of Print:
16 oct 2021
Resumen:
Background: Age, sex, race and comorbidities are insufficient to explain why some individuals remain asymptomatic after SARS-CoV-2 infection, while others die. In this sense, the increased risk caused by the long-term exposure to air pollution is being investigated to understand the high heterogeneity of the COVID-19 infection course. Objectives: We aimed to assess the underlying effect of long-term exposure to NO2 and PM10 on the severity and mortality of COVID-19. Methods: A retrospective observational study was conducted with 2112 patients suffering COVID-19 infection. We built two sets of multivariate predictive models to assess the relationship between the long-term exposure to NO2 and PM10 and COVID-19 outcome. First, the probability of either death or severe COVID-19 outcome was predicted as a function of all the clinical variables together with the pollutants exposure by means of two regularized logistic regressions. Subsequently, two regularized linear regressions were constructed to predict the percentage of dead or severe patients. Finally, odds ratios and effects estimates were calculated. Results: We found that the long-term exposure to PM10 is a more important variable than some already stated comorbidities (i.e.: COPD/Asthma, diabetes, obesity) in the prediction of COVID-19 severity and mortality. PM10 showed the highest effects estimates (1.65, 95% CI 1.32–2.06) on COVID-19 severity. For mortality, the highest effect estimates corresponded to age (3.59, 95% CI 2.94–4.40), followed by PM10 (2.37, 95% CI 1.71–3.32). Finally, an increase of 1 µg/m3 in PM10 concentration causes an increase of 3.06% (95% CI 1.11%-4.25%) of patients suffering COVID-19 as a severe disease and an increase of 2.68% (95% CI 0.53%-5.58%) of deaths. Discussion: These results demonstrate that long-term PM10 burdens above WHO guidelines exacerbate COVID-19 health outcomes. Hence, WHO guidelines, the air quality standard established by the Directive 2008/50/EU, and that of the US-EPA should be updated accordingly to protect human health. © 2021 The Author(s)
Filiaciones:
Marquès M.:
Universitat Rovira i Virgili, Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Sant Llorenç 21, Reus, Catalonia 43201, Spain
Correig E.:
Universitat Rovira i Virgili, Department of Biostatistics, Sant Llorenç 21, Reus, Catalonia 43201, Spain
Ibarretxe D.:
Universitat Rovira i Virgili, LIPIDCAS, University Hospital Sant Joan IISPV, CIBERDEM, Reus, Spain
Anoro E.:
LIPIDCAS, Pius Hospital Valls, Valls, Spain
Antonio Arroyo J.:
Lipid Unit, University Hospital Santa Creu i Sant Pau, Barcelona Autonomous University, Barcelona, Spain
Jericó C.:
Lipid Unit, Hospital Moises Broggi. Consorci Sanitari Integral. Sant Joan Despí, Spain
Borrallo R.M.:
Internal Medicine Department, Terrasa Hospital. Consorci Sanitari Terrassa, Spain
Miret M.:
LIPIDCAS, Endocrinology Department, Hospital Verge de la Cinta, Tortosa, Spain
Näf S.:
LIPIDCAS, Endocrinology Department, University Hospital Joan XXIII, IISPV. CIBERDEM. Universitat Rovira i Virgili. Tarragona, Spain
Pardo A.:
Internal Medicine Department, Hospital Delfos, Barcelona, Spain
Perea V.:
Lipid Unit, Hospital Mutua Terrasa, Barcelona, Spain
Pérez-Bernalte R.:
LIPIDCAS, Hospital del Vendrell, El Vendrell, Spain
Ramírez-Montesinos R.:
LIPIDCAS, Hospital Sant Pau i Santa Tecla, Tarragona, Spain
Royuela M.:
Lipid Unit, ALTHAIA, Xarxa Assistencial Universitària de Manresa, Spain
Soler C.:
Lipid Unit, Hospital Santa Caterina, Girona, Spain
Urquizu-Padilla M.:
Lipid Unit, University Hospital Vall d'Hebron, Barcelona Autonomous University, Barcelona, Spain
Zamora A.:
Lipid Unit, Corporació de Salut del Maresme i la Selva, Hospital de Blanes, Spain
Pedro-Botet J.:
Lipid Unit, University Hospital del Mar, Barcelona Autonomous University, Barcelona, Spain
Masana L.:
Universitat Rovira i Virgili, LIPIDCAS, University Hospital Sant Joan IISPV, CIBERDEM, Reus, Spain
Domingo J.L.:
Universitat Rovira i Virgili, Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Sant Llorenç 21, Reus, Catalonia 43201, Spain
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