Chronic exposure to air pollution may increase risks for ICU admission
or death among COVID-19 patients, study finds

Date:
December 9, 2021
Source:
The Mount Sinai Hospital / Mount Sinai School of Medicine
Summary:
A new study suggests that persistent exposure to air pollutants
in residential communities can impact health outcomes for COVID-19
patients.



FULL STORY ========================================================================== Hospitalized COVID-19 patients who had been chronically exposed in their neighborhoods to higher particulate matter -- such as smoke, soot, and
dirt - - had increased risks for admission to the intensive care unit
(ICU) and death compared to those without such exposure, Mount Sinai-led researchers reported in the American Journal of Respiratory and Critical
Care Medicineon December 8.


==========================================================================
The finding adds to our understanding about environmental factors that
increase the risks of COVID-19. The researchers noted that chronic air pollution exposure can alter the pulmonary immune system, may increase
systemic inflammation, and can be associated with increased risk for cardiovascular disease and metabolic syndrome. COVID-19 infections and
deaths have also disproportionately occurred among Black, Latinx, and Indigenous populations, as well as among individuals with risk factors
based on sex, age, and existing comorbid diseases such as diabetes
and obesity.

"The COVID-19 pandemic has brought to the forefront the critical role of
the environment on health disparities. These data suggest that long-term exposure to air pollution, even at concentrations below U.S. Environmental Protection Agency regulatory standards, is associated with higher COVID-19 morbidity and mortality amongst hospitalized patients," said corresponding author Alison Lee, MD, MS, Assistant Professor of Medicine (Pulmonary,
Critical Care and Sleep Medicine), and Pediatrics, at the Icahn School
of Medicine at Mount Sinai.

"Critically, air pollution is a modifiable risk factor. Policies to reduce
air pollution must be considered a necessary public health measure,
especially in communities that are disproportionately susceptible to
air pollution's deleterious effects." A team of researchers conducted a retrospective analysis of more than 6,500 COVID-19 patients admitted to
seven New York City hospitals with ethnically diverse patient populations
-- including Mount Sinai Morningside, Mount Sinai Queens, NYC Health + Hospitals/Elmhurst, and NYC Health + Hospitals/Queens - - amid the first
peak of the pandemic from March to August 2020. The researchers estimated exposure levels to pollutants including particulate matter, nitrogen
dioxide, and black carbon at the residential addresses of the patients at
the time of admission. The team then assessed patient outcomes including mortality, ICU admission, and intubation. They found that chronic exposure
to particulate matter, even at levels below current regulatory thresholds,
was associated with an 11 percent higher risk of mortality and 13 percent higher risk of admission to the ICU. Exploratory analyses suggested that younger people of color may be particularly susceptible.

The study was developed through participation in the COVID-19 Unit for
Research at Elmhurst (CURE-19) partnership, an initiative by Mount Sinai's Arnhold Institute for Global Health and NYC Health + Hospitals/Elmhurst
and Queens to research the global pandemic and root causes of health disparities in New York City.

"There is a lot we still don't know about coronavirus, and that is why initiatives like the CURE-19 partnership are of utmost importance in the
fight against this pandemic and our continued recovery," said co-author
Stanley Pierre, MD, MPA, NYC Health + Hospitals/Queens Patient Safety Coordinator and Director of the Clinical Centers of Excellence Development Program. "Being able to better understand what and how environmental
factors play a role in New Yorkers' health and COVID-19-associated risks
not only allow us to better treat patients in the long-term, but also
give us the opportunity to advocate for broader changes that can help
prevent serious illness in the future." In addition to researchers
from CURE-19, experts from Columbia University and the University of California, Berkeley contributed to the study. It was supported by grants
from the National Institute on Minority Health and Health Disparities (R01MD013310), the National Institute of Environmental Health Sciences (P30ES023515, P30ES009089), the Eunice Kennedy Shriver National Institute
of Child Health and Human Development (P2CHD058486), and the National
Heart, Lung and Blood Institute (K23HL135349).

========================================================================== Story Source: Materials provided by The_Mount_Sinai_Hospital_/_Mount_Sinai_School_of Medicine. Note: Content
may be edited for style and length.


========================================================================== Journal Reference:
1. Anne Bozack, Stanley Pierre, Nicholas DeFelice, Elena Colicino,
Darby
Jack, Steven N Chillrud, Andrew Rundle, Alfred Astua, James
W. Quinn, Laura McGuinn, Qiang Yang, Keely Johnson, Joseph Masci,
Laureen Lukban, Duncan Maru, Alison G Lee. Long-Term Air Pollution
Exposure and COVID-19 Mortality: A Patient-Level Analysis from
New York City. American Journal of Respiratory and Critical Care
Medicine, 2021; DOI: 10.1164/ rccm.202104-0845OC ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/12/211209124330.htm

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