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Nature Research, Nature Communications, 1(14), 2023

DOI: 10.1038/s41467-023-38469-7

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Long-term exposure to air pollution and severe COVID-19 in Catalonia: a population-based cohort study

Journal article published in 2023 by Otavio Ranzani ORCID, Anna Alari, Sergio Olmos, Carles Milà, Alex Rico, Joan Ballester ORCID, Xavier Basagaña ORCID, Carlos Chaccour ORCID, Payam Dadvand ORCID, Talita Duarte-Salles ORCID, Maria Foraster, Mark Nieuwenhuijsen, Jordi Sunyer, Antònia Valentín ORCID, Manolis Kogevinas and other authors.
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

AbstractThe association between long-term exposure to ambient air pollutants and severe COVID-19 is uncertain. We followed 4,660,502 adults from the general population in 2020 in Catalonia, Spain. Cox proportional models were fit to evaluate the association between annual averages of PM2.5, NO2, BC, and O3 at each participant’s residential address and severe COVID-19. Higher exposure to PM2.5, NO2, and BC was associated with an increased risk of COVID-19 hospitalization, ICU admission, death, and hospital length of stay. An increase of 3.2 µg/m3 of PM2.5 was associated with a 19% (95% CI, 16–21) increase in hospitalizations. An increase of 16.1 µg/m3 of NO2 was associated with a 42% (95% CI, 30–55) increase in ICU admissions. An increase of 0.7 µg/m3 of BC was associated with a 6% (95% CI, 0–13) increase in deaths. O3 was positively associated with severe outcomes when adjusted by NO2. Our study contributes robust evidence that long-term exposure to air pollutants is associated with severe COVID-19.