Headline: Air quality in Germany as a contributing factor to morbidity from COVID-19

Background: The SARS-CoV-2 virus has been spreading in Germany since January 2020, with regional differences in incidence, morbidity, and mortality. Long-term exposure to air pollutants as nitrogen dioxide (NO2), nitrogen monoxide (NO), ozone (O3), and particulate matter (<10µm PM10, < 2.5µm PM2.5,) has a negative impact on respiratory functions. We analyze the association between long-term air pollution and the outcome of SARS-CoV-2 infections in Germany. Methods: We conducted a cross-sectional study in Germany on county-level, investigating the association between long-term (2010-2019) air pollutant exposure and COVID-19 incidence, morbidity, and mortality rate during the rst outbreak of SARS-CoV-2. We used negative binominal models, including adjustment for risk factors (age, sex, days since rst COVID-19 case, population density, socio-economic and health parameters). Results: After adjustment for risk factors in the tri-pollutant model (NO2, O3, PM2.5) an increase of 1µg/m³ NO2 was associated with an increase of the need for intensive care due to COVID-19 by 4.2% (95% CI 1.011–1.074), and mechanical ventilation by 4.6% (95% CI 1.010–1.084). A tendency towards an association of NO2 with COVID-19 incidence was indicated, as the results were just outside of the de ned statistical signi cance (+1.6% (95% CI 1.000 -1.032)). Long-term annual mean NO2 level ranged from 4.6µg/m³ to 32µg/m³. Conclusions: Our results indicate that long-term NO2 exposure may have increased susceptibility for COVID-19 morbidity in Germany. The results demonstrate the need to reduce ambient air pollution to improve public health.

Publication Year
2022
Publication Type
Academic Articles
Citation

Koch, S., Hoffmann, C., Caseiro, A., Ledebur, M., Menk, M., & von Schneidemesser, E. (2022). Air quality in Germany as a contributing factor to morbidity from COVID-19. Research Square. doi:10.21203/rs.3.rs-1500689/v1.

DOI
10.21203/rs.3.rs-1500689/v1
Links
https://publications.iass-potsdam.de/rest/items/item_6001745_1/component/file_6…
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