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- W4316924836 abstract "Background and Aim After the outbreak of SARS-CoV-2 pandemic in 2019, there has been a fast proliferation of epidemiological studies linking ambient air pollution to COVID-19 incidence or adverse prognosis. However, the role of chronic exposure to air pollutants in increasing COVID-19 fatality is still unclear. Methods From the national surveillance database, we selected all COVID-19 cases from February 2020 to June 2021. We developed an air pollution exposure model with 1-km2 resolution for Italy, and assigned 2016-2019 mean concentrations of particulate matter < 10 micron (PM10), PM < 2.5 micron (PM2.5) and nitrogen dioxide (NO2) to each municipality (n=7,800) as estimates of chronic exposures. We applied a principal component analysis and a generalized propensity score (GPS) approach to an extensive list of area-level covariates related to geography and topography, population density, mobility, population health, socio-economic status, and access to healthcare services. Finally, we applied generalized negative-binomial regression models matched on GPS, age, sex, province and month. Results We analyzed 3,995,202 COVID-19 cases which generated 124,346 deaths. Case-fatality rates (CFR) increased by 0.7% (95% confidence intervals [CI]: 0.5%, 0.9%), 0.3% (95% CI: 0.2%, 0.5%) and 0.6% (95% CI: 0.5%, 0.8%) per 1 μg/m3 increment in PM2.5, PM10 and NO2, respectively. Associations were higher among elderly subjects, they did not differ by sex or pre-existing diseases, and were higher during the first (Feb. 2020 – June 2020) and the third (Dec. 2020- June 2021) pandemic waves. In two-pollutant models, NO2 estimates were robust to PM adjustment, while PM estimates became null after adjustment for NO2. Conclusions We found suggestive evidence of association between long-term exposure to ambient air pollutants with mortality among ~ 4 million COVID-19 cases in Italy, highlighting the role of chronic air pollution exposure on the vulnerability of the exposed population. KEYWORDS Air pollution, COVID-19, generalized propensity score" @default.
- W4316924836 created "2023-01-18" @default.
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- W4316924836 date "2022-09-18" @default.
- W4316924836 modified "2023-10-16" @default.
- W4316924836 title "Long-term exposure to ambient air pollution and COVID-19 fatality in Italy" @default.
- W4316924836 doi "https://doi.org/10.1289/isee.2022.p-0660" @default.
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