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Air pollution in relation to COVID-19 morbidity and mortality: A large population-based cohort study in Catalonia, Spain (COVAIR-CAT)
This study will test whether long- or short-term exposure to air pollution increases the risk of COVID-19 hospital admissions or mortality and identify vulnerable subgroups among 6 million residents of Catalonia, Spain. The investigators will link air pollution exposures to residents’ addresses and inpatient and outpatient electronic medical records.
Poster abstract for HEI Annual Conference 2022
Air pollution in relation to COVID-19 morbidity and mortality: a large population-based study in Catalonia, Spain (COVAIR-CAT)
Cathryn Tonne1, Anna Alari1, Carla Avellaneda2, Joan Ballester1, Xavier Basagaña1, Carlos Chaccour1, Payam Dadvand1, Talita Duarte-Salles3, Maria Foraster1, Carles Milà1, Mark Nieuwenhuijsen1, Sergio Olmos1, Otavio Ranzani1, Alex Rico1, Jordi Sunyer1, Antònia Valentín1, Rosa Vivanco4
1ISGlobal, Barcelona, Spain; 2Institut Hospital del Mar d’Investigacions Mèdiques, 3IDIAPJGOL, Barcelona, Spain Barcelona, Spain; 4Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain
Background. Increasing evidence from epidemiological studies based on individual-level data indicate that air pollution exposure may be associated with severity of COVID-19. We aimed to test whether: 1) long-term exposure to air pollution is associated with COVID-19 hospital admission or mortality in the general population; 2) short-term exposure to air pollution is associated with COVID-19 hospital admission or mortality following COVID-19 diagnosis; 3) there are vulnerable population subgroups; and 4) the influence of long-term air pollution exposure on COVID-19 hospital admissions and mortality differed from that for respiratory infections not due to SARS-CoV-2 infection.
Methods. We constructed a cohort covering nearly the full population of Catalonia through electronic health record linkage, with follow up from 1 Jan 2015 to Dec 31 2020. Exposures at residential address were estimated using the ELAPSE models and newly developed spatio-temporal models of PM2.5, PM10, NO2, and maximum 8h-average O3 at a spatial resolution of 250m for the period 2018-2020 covering the area of Catalonia.
Results. The general population cohort includes 5,129,235 individuals; in 2020 there were 342,269 COVID-19 diagnoses, 47,619 COVID-19 hospital admissions, and 10,964 COVID-19 deaths. Mean (sd) exposures based on ELAPSE models were 11.7 (2.4) µg/m3 for PM2.5, 29.1 (10.6) µg/m3 for NO2, and 71.2 (8.5) µg/m3 for O3. Cross validation R2 from the spatio-temporal models ranged from 0.61 for PM2.5 to 0.87 for O3. Epidemiological analyses are ongoing.
Conclusions. Linkage across several electronic health record databases allowed for the construction of a large population-based cohort, tracking COVID-19 cases from primary care and testing data to hospital admissions, and/or death. Spatio-temporal model accuracy varied depending on the pollutant.
