到达:种族,种族和空气污染在COVID-19住院治疗中OUTcomes
J A Stingone1, S Lovinsky-Desir2, S Kannoth1
1Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
长期暴露于空气污染,特别是二氧化 (NO2) 和细颗粒物 (PM2.5),增加了纽约脆弱社区的COVID-19发病风险. 然而,对于死亡和机械通风风险,发现了相反的关联.
科学领域:
- 环境健康 环境健康
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 长期暴露于空气污染与健康差异有关,可能会恶化COVID-19的结果.
- 社会和结构因素增加了对环境暴露和不良COVID-19结果的脆弱性.
- 检查组合的不利因素对于了解污染对纽约市COVID-19差异的影响至关重要.
研究的目的:
- 估计慢性空气污染物暴露对COVID-19发病率和死亡率的影响.
- 为了确定空气污染对COVID-19结果的影响是否因邻里脆弱性而有所不同.
- 为了解释在纽约市观察到的COVID-19差异.
主要方法:
- 利用来自纽约五个医疗保健系统的COVID-19患者的EHR数据 (2020年3月至2021年2月).
- 估计的空气污染物度 (NO2,PM2.5,BC,O3) 使用邮政编码水平的平均值 (2009-2019).
- 采用考克斯和波松回归模型,调整共变量和邻近环境脆弱性指数 (NEVI),以评估污染物影响和相互作用.
主要成果:
- NO2,PM2.5和BC暴露与ARDS,肺炎和透析的风险增加有关.
- 在NO2,PM2.5,BC和死亡风险和机械通风之间观察到意想不到的反向关联.
- 空气污染和COVID-19发病率之间的积极关联在NEVI较高的地区更强,种族差异持续存在.
结论:
- 像ARDS,肺炎和透析等COVID-19发病率与空气污染物暴露有关,特别是在脆弱的社区.
- 空气污染与严重结果 (死亡,机械通风) 之间的意外反向关联突出了人口水平研究的挑战.
- 邻近地区的环境脆弱性显著改变了空气污染和COVID-19发病率之间的联系.
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