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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)

Principal Investigator: 
,

Barcelona Institute for Global Health (ISGlobal), Spain

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.

Funded under
Status: 
Ongoing
Abstract

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.