长期暴露于空气污染物对 SARS-CoV-2 感染和严重程度的交互影响:一项基于意大利北部人群的队列研究。

IF 4.7 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Giovanni Veronesi, Sara De Matteis, Camillo Silibello, Emanuele M Giusti, Walter Ageno, Marco M Ferrario
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引用次数: 0

摘要

背景:我们研究了长期暴露于颗粒物(PM 10)、二氧化氮(NO 2)和臭氧(O 3)对 SARS-CoV-2 感染性和严重程度的交互作用:我们对瓦雷泽省的 709 864 名成年居民进行了跟踪调查,时间从 2020 年 2 月 1 日开始,直到首次检测呈阳性、COVID-19 住院或死亡,直至 2020 年 12 月 31 日。我们利用化学传输模型和随机森林模型估算了 2019 年居民区 PM 10、NO 2 和 O 3 的年均值。我们利用经社会人口因素和合并症调整的 Cox 回归模型估算了污染物与城市化程度对 SARS-CoV-2 感染率、住院率和死亡率终点的交互影响,并利用泊松模型估算了交互影响导致的额外病例:41,065人受到感染,5,203人住院治疗,1,543人在随访期间死于COVID-19。PM 10 的平均值比世界卫生组织的限值高 1.6 倍,NO 2 的平均值比世界卫生组织的限值高 2.6 倍,城市和非城市地区之间的梯度很大。PM 10 和 NO 2 与 SARS-CoV-2 感染率和死亡率呈正相关,PM 10 与城市地区的住院率呈正相关。据交互分析估计,PM 10(每 3.5 微克/米 3)对感染率的影响在城市地区最强(HR=1.12,95%CI:1.09-1.16),相当于每 10 万人年增加 854 个病例,在二氧化氮共同暴露水平较高的地区也是如此(HR=1.15,1.08-1.22)。在 PM 10 共同暴露水平较高的地区,臭氧的保护作用发生逆转(HR=1.32,1.17-1.49),O 3 每增加 1 µg/m 3,病例数增加 278 例。我们对严重性终点的交互效应进行了类似的估计:我们估计,污染物之间的交互效应加剧了 SARS-CoV-2 在城市地区的流行。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Interactive effects of long-term exposure to air pollutants on SARS-CoV-2 infection and severity: a northern Italian population-based cohort study.

Background: We examined interactions, to our knowledge not yet explored, between long-term exposures to particulate matter (PM 10 ) with nitrogen dioxide (NO 2 ) and ozone (O 3 ) on SARS-CoV-2 infectivity and severity.

Methods: We followed 709,864 adult residents of Varese Province from 1 February 2020 until the first positive test, COVID-19 hospitalization, or death, up to 31 December 2020. We estimated residential annual means of PM 10 , NO 2 and O 3 in 2019 from chemical-transport and random-forest models. We estimated interactive effects of pollutants with urbanicity on SARS-CoV-2 infectivity, hospitalization, and mortality endpoints using Cox regression models adjusted for socio-demographic factors and comorbidities, and additional cases due to interactions using Poisson models.

Results: 41,065 individuals were infected, 5,203 were hospitalized and 1,543 died from COVID-19 during follow-up. Mean PM 10 was 1.6 times higher and NO 2 2.6 times higher than WHO limits, with wide gradients between urban and non-urban areas. PM 10 and NO 2 were positively associated with SARS-CoV-2 infectivity and mortality, and PM 10 with hospitalizations in urban areas. Interaction analyses estimated that the effect of PM 10 (per 3.5 µg/m 3 ) on infectivity was strongest in urban areas (HR=1.12, 95%CI:1.09-1.16), corresponding to 854 additional cases per 100,000 person-years, and in areas at high NO 2 co-exposure (HR=1.15, 1.08-1.22). At higher levels of PM 10 co-exposure the protective association of ozone reversed (HR=1.32, 1.17-1.49), yielding to 278 additional cases per µg/m 3 increase in O 3 . We estimated similar interactive effects for severity endpoints.

Conclusions: We estimate that interactive effects between pollutants exacerbated the burden of SARS-CoV-2 pandemic in urban areas.

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来源期刊
Epidemiology
Epidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.70
自引率
3.70%
发文量
177
审稿时长
6-12 weeks
期刊介绍: Epidemiology publishes original research from all fields of epidemiology. The journal also welcomes review articles and meta-analyses, novel hypotheses, descriptions and applications of new methods, and discussions of research theory or public health policy. We give special consideration to papers from developing countries.
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