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Study: More air pollution, worse COVID-19 outcomes

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The air people breathe – and the amount of pollution it contains – can make a difference in their outcomes when infected with COVID-19, according to a new study.

The researchers found that living in more polluted areas – including near sewage landfills and near heavy traffic – was linked to a greater likelihood of being admitted to the intensive care unit and to a greater likelihood of needing mechanical ventilation after infection with COVID-19.

“The main takeaway is that living in a more polluted neighborhood is an independent risk factor for severity of COVID-19 disease,” said study author Dr Anita Shallal of Henry Hospital. Ford of Detroit.

According to the American Lung Association, Detroit is the 12th most polluted city in the United States, measured by fine particle pollution year-round.

Because low-income and minority populations often live in more polluted areas, the study “also draws attention to systemic inequalities that may have led to stark differences in COVID-19 outcomes across racial lines and ethnic, ”Shallal said.

“Communities of color are more likely to be located in areas closer to industrial pollution and to work in businesses that expose them to air pollution,” Shallal said.

The new research is to be presented at the annual online meeting of the European Congress of Clinical Microbiology and Infectious Diseases.

Dr Theodore Maniatis, medical director of Staten Island University Hospital in New York City, said the results “made perfect sense”.

He said the lungs operate in a “delicate balance” which is easily compromised by dirty air. Anything that upsets that balance “will likely increase the risk of lung infections and decrease the ability of the lungs to clear those infections,” said Maniatis, who was not a part of the new study.

In the study, Shallal’s team collected data on where participants lived as well as data from the Environmental Protection Agency and other sources on local levels of pollutants, including PM2.5, l ozone and lead paint.

They used this data to explore associations between COVID-19 findings and exposure to a variety of pollutants.

The results: COVID-19 patients who lived in areas with higher levels of PM2.5 and lead paint were more likely to need mechanical ventilation and be admitted to the ICU, per compared to those living in less polluted neighborhoods.

In fact, every small increase in long-term exposure to PM2.5 was associated with more than three times the chance of being mechanically ventilated and twice the likelihood of staying in intensive care.

However, it was not associated with a greater risk of death, the study team reported.

They note that the study could not prove cause and effect, only that pollution was associated with worse COVID-19 outcomes.

Researchers also found greater risks for patients who are male, black, obese, or with serious long-term health problems. They were much more likely to need mechanical ventilation and be admitted to the ICU.

According to the study, being male, obese, or having serious long-term health problems were also predictors of death after admission.

Speaking in a press release, Shallal said it was not yet clear “how air pollutants contribute to more serious diseases.”

But she speculated that “it is possible that long-term exposure to air pollution can alter the immune system, leading to both increased susceptibility to viruses and more serious viral infections.”

Added to this, “fine particles from air pollution can also act as a vector for the virus, increasing its spread,” Shallal said. “Urgent additional research is needed to guide policy and environmental protection, to minimize the impact of COVID-19 in the highly industrialized communities that are home to our most vulnerable residents.”

Dr. Irene Galperin is chief of pulmonary medicine at Long Island Jewish Forest Hills, New York. Reviewing the results, she noted that “inhaling fine particles can lead to chronic inflammation, a reduced immune response, and a reduced ability of the lung to heal and repair itself.”

Galperin stated that, “on the basis of this latest study, [it’s possible that] patients with a history of such exposure are more likely to develop severe COVID 19 disease. “

Experts note that results presented at medical meetings are considered preliminary until published in a peer-reviewed journal.

More information

The National Institute of Environmental Health Sciences has more on pollution and health.

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