{"doi":"10.1164/rccm.202108-1909oc","title":"Ambient Air Pollutant Exposures and COVID-19 Severity and Mortality in a Cohort of Patients with COVID-19 in Southern California","abstract":"Abstract Rationale Ecological studies have shown air pollution associations with coronavirus disease (COVID-19) outcomes. However, few cohort studies have been conducted. Objectives To conduct a cohort study investigating the association between air pollution and COVID-19 severity using individual-level data from the electronic medical record. Methods This cohort included all individuals who received diagnoses of COVID-19 from Kaiser Permanente Southern California between March 1 and August 31, 2020. One-year and 1-month averaged ambient air pollutant (particulate matter ⩽2.5 μm in aerodynamic diameter [PM2.5], NO2, and O3) exposures before COVID-19 diagnosis were estimated on the basis of residential address history. Outcomes included COVID-19–related hospitalizations, intensive respiratory support (IRS), and ICU admissions within 30 days and mortality within 60 days after COVID-19 diagnosis. Covariates included socioeconomic characteristics and comorbidities. Measurements and Main Results Among 74,915 individuals (mean age, 42.5 years; 54% women; 66% Hispanic), rates of hospitalization, IRS, ICU admission, and mortality were 6.3%, 2.4%, 1.5%, and 1.5%, respectively. Using multipollutant models adjusted for covariates, 1-year PM2.5 and 1-month NO2 average exposures were associated with COVID-19 severity. The odds ratios associated with a 1-SD increase in 1-year PM2.5 (SD, 1.5 μg/m3) were 1.24 (95% confidence interval [CI], 1.16–1.32) for COVID-19–related hospitalization, 1.33 (95% CI, 1.20–1.47) for IRS, and 1.32 (95% CI, 1.16–1.51) for ICU admission; the corresponding odds ratios associated with 1-month NO2 (SD, 3.3 ppb) were 1.12 (95% CI, 1.06–1.17) for hospitalization, 1.18 (95% CI, 1.10–1.27) for IRS, and 1.21 (95% CI, 1.11–1.33) for ICU admission. The hazard ratios for mortality were 1.14 (95% CI, 1.02–1.27) for 1-year PM2.5 and 1.07 (95% CI, 0.98–1.16) for 1-month NO2. No significant interactions with age, sex or ethnicity were observed. Conclusions Ambient PM2.5 and NO2 exposures may affect COVID-19 severity and mortality.","journal":"American Journal of Respiratory and Critical Care Medicine","year":2022,"id":238491,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":54,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6062,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":484945,"name":"Margo A. Sidell","orcid":"0000-0001-7963-4505","position":1,"is_corresponding":false},{"id":400256,"name":"Brian Z. Huang","orcid":"0000-0001-8645-5142","position":2,"is_corresponding":false},{"id":460689,"name":"Ting Chow","orcid":"0000-0001-6175-1818","position":3,"is_corresponding":false},{"id":307227,"name":"Sandrah P. Eckel","orcid":"0000-0001-6050-7880","position":4,"is_corresponding":false},{"id":524294,"name":"Mayra P. Martinez","orcid":"0000-0002-6134-606X","position":5,"is_corresponding":false},{"id":862068,"name":"Roya Gheissari","orcid":"0000-0002-4796-2333","position":6,"is_corresponding":false},{"id":433052,"name":"Fred Lurmann","orcid":null,"position":7,"is_corresponding":false},{"id":25148,"name":"Duncan C. Thomas","orcid":"0000-0002-6040-8804","position":8,"is_corresponding":false},{"id":75356,"name":"Frank D. Gilliland","orcid":"0000-0002-9033-7269","position":9,"is_corresponding":false},{"id":370816,"name":"Anny H. Xiang","orcid":"0000-0003-2786-1268","position":10,"is_corresponding":false},{"id":247726,"name":"Zhanghua Chen","orcid":"0000-0002-6424-6697","position":0,"is_corresponding":true}],"reference_count":40,"raw_metadata":null,"created_at":"2026-07-19T00:22:26.932537Z","pmid":"35537137","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}