{"doi":"10.1289/ehp9726","title":"Ambient Air Pollution in Relation to SARS-CoV-2 Infection, Antibody Response, and COVID-19 Disease: A Cohort Study in Catalonia, Spain (COVICAT Study)","abstract":"Background: Emerging evidence links ambient air pollution with coronavirus 2019 (COVID-19) disease, an association that is methodologically challenging to investigate. Objectives: We examined the association between long-term exposure to air pollution with SARS-CoV-2 infection measured through antibody response, level of antibody response among those infected, and COVID-19 disease. Methods: We contacted 9,605 adult participants from a population-based cohort study in Catalonia between June and November 2020; most participants were between 40 and 65 years of age. We drew blood samples from 4,103 participants and measured immunoglobulin M (IgM), IgA, and IgG antibodies against five viral target antigens to establish infection to the virus and levels of antibody response among those infected. We defined COVID-19 disease using self-reported hospital admission, prior positive diagnostic test, or more than three self-reported COVID-19 symptoms after contact with a COVID-19 case. We estimated prepandemic (2018–2019) exposure to fine particulate matter [PM with an aerodynamic diameter of ≤2.5μm (PM2.5)], nitrogen dioxide (NO2), black carbon (BC), and ozone (O3) at the residential address using hybrid land-use regression models. We calculated log-binomial risk ratios (RRs), adjusting for individual- and area-level covariates. Results: Among those tested for SARS-CoV-2 antibodies, 743 (18.1%) were seropositive. Air pollution levels were not statistically significantly associated with SARS-CoV-2 infection: Adjusted RRs per interquartile range were 1.07 (95% CI: 0.97, 1.18) for NO2, 1.04 (95% CI: 0.94, 1.14) for PM2.5, 1.00 (95% CI: 0.92, 1.09) for BC, and 0.97 (95% CI: 0.89, 1.06) for O3. Among infected participants, exposure to NO2 and PM2.5 were positively associated with IgG levels for all viral target antigens. Among all participants, 481 (5.0%) had COVID-19 disease. Air pollution levels were associated with COVID-19 disease: adjusted RRs=1.14 (95% CI: 1.00, 1.29) for NO2 and 1.17 (95% CI: 1.03, 1.32) for PM2.5. Exposure to O3 was associated with a slightly decreased risk (RR=0.92; 95% CI: 0.83, 1.03). Associations of air pollution with COVID-19 disease were more pronounced for severe COVID-19, with RRs=1.26 (95% CI: 0.89, 1.79) for NO2 and 1.51 (95% CI: 1.06, 2.16) for PM2.5. Discussion: Exposure to air pollution was associated with a higher risk of COVID-19 disease and level of antibody response among infected but not with SARS-CoV-2 infection. https://doi.org/10.1289/EHP9726","journal":"Environmental Health Perspectives","year":2021,"id":151110,"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":86,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9527,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":321672,"name":"Gemma Castaño‐Vinyals","orcid":"0000-0003-4468-1816","position":1,"is_corresponding":false},{"id":467780,"name":"Marianna Karachaliou","orcid":"0000-0002-3014-0747","position":2,"is_corresponding":false},{"id":642335,"name":"Ana Espinosa","orcid":"0000-0001-7399-3267","position":3,"is_corresponding":false},{"id":642336,"name":"Rafael de Cid","orcid":"0000-0003-3579-6777","position":4,"is_corresponding":false},{"id":281739,"name":"Judith García‐Aymerich","orcid":"0000-0002-7097-4586","position":5,"is_corresponding":false},{"id":642337,"name":"Anna Carreras","orcid":"0000-0002-8789-067X","position":6,"is_corresponding":false},{"id":642338,"name":"Beatriz Cortés","orcid":"0000-0002-2656-7051","position":7,"is_corresponding":false},{"id":643554,"name":"Vanessa Pleguezuelos","orcid":null,"position":8,"is_corresponding":false},{"id":642339,"name":"Alfons Jiménez","orcid":"0000-0003-0301-3344","position":9,"is_corresponding":false},{"id":341242,"name":"Marta Vidal","orcid":"0000-0001-6891-7032","position":10,"is_corresponding":false},{"id":642340,"name":"Cristina O’Callaghan‐Gordo","orcid":"0000-0002-4229-2991","position":11,"is_corresponding":false},{"id":642341,"name":"Marta Cirach","orcid":"0000-0002-5518-1529","position":12,"is_corresponding":false},{"id":642342,"name":"Rebeca Santano","orcid":"0000-0002-0007-5315","position":13,"is_corresponding":false},{"id":642343,"name":"Diana Barrios","orcid":"0000-0001-9929-5707","position":14,"is_corresponding":false},{"id":642344,"name":"Laura Puyol","orcid":"0000-0003-2840-7753","position":15,"is_corresponding":false},{"id":642345,"name":"Rocío Rubio","orcid":"0000-0002-0448-3404","position":16,"is_corresponding":false},{"id":418378,"name":"Luís Izquierdo","orcid":"0000-0002-3704-9874","position":17,"is_corresponding":false},{"id":23197,"name":"Mark Nieuwenhuijsen","orcid":"0000-0001-9461-7981","position":18,"is_corresponding":false},{"id":393363,"name":"Payam Dadvand","orcid":"0000-0002-2325-1027","position":19,"is_corresponding":false},{"id":341244,"name":"Ruth Aguilar","orcid":"0000-0003-3277-3107","position":20,"is_corresponding":false},{"id":258301,"name":"Gemma Moncunill","orcid":"0000-0001-5105-9836","position":21,"is_corresponding":false},{"id":258300,"name":"Carlota Dobaño","orcid":"0000-0002-6751-4060","position":22,"is_corresponding":false},{"id":342783,"name":"Cathryn Tonne","orcid":"0000-0003-3919-8264","position":23,"is_corresponding":false},{"id":240094,"name":"Manolis Kogevinas","orcid":"0000-0002-9605-0461","position":0,"is_corresponding":true}],"reference_count":49,"raw_metadata":null,"created_at":"2026-07-18T23:43:11.293086Z","pmid":"34787480","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":[]}