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Individual and Environmental Risk Factors for COVID-19 Mortality in Elderly in 7 European University Hospitals

Journal of Environmental Protection 2022年第7期13卷 508-526页

作者： Thomas Bourdrel leo Zabrocki Nathalie Compte Bert Bravenboer Romain decours Hélène Pelerin Laure de decker laurence le jumeau de kergaradec Matthieu Lilamand Claire Roubaud Baudron Bertrand Fougère Rachid Mahmoudi Benoit Schorr Georges Kaltenbach Thomas Vogel Vincent-Henri Puech Fréderic Blanc Marie-Abèle Bind ICube Laboratory UMR 7357 and CNRS University of Strasbourg Strasbourg France Paris School of Economics EHESS Paris France Geriatric department Universitair Ziekenhuis Brussel Bruxelles Belgium Service de Gé riatrie Centre hospitalier d&eacute partemental de Vendé e La Roche Sur Yon France Unité de recherche clinique Centre hospitalier d&eacute partemental de Vendé e La Roche Sur Yon France Service de Mé decine aigü e gé riatrique Centre hospitalier universitaires de Nantes Nantes France Service de Gé rontologie Centre hospitalier universitaires de Nantes Nantes France Service de Gé riatrie Assistance publique Hô pitaux de Paris (APHP) Nord Paris France Unité Post Urgences Gé riatriques Centre hospitalier universitaire de Bordeaux H&ocirc pital Pellegrin Bordeaux France department of Geriatric Medicine Centre hospitalier universitaire de Tours Tours France Mé decine Interne Gé riatrie et Biologie du Vieillissement Centre hopitalier universitaire de Reims Reims France Pô le de Gé riatrie La Robertsau Geriatric Hospital University Hospital of Strasbourg Strasbourg France European Centre for Medium-Range Weather Forecasts Copernicus Atmosphere Monitoring Service London UK Biostatistics Center Massachusetts General Hospital Boston MA USA

Because the elderly account for 80% of deaths from COVID-19 and they may be more vulnerable to air pollution, in this retrospective study we aimed to explore individual and environmental risk factors for COVID-19 mortality in the geriatric departments of seven European University hospitals, between February and May 2020. Long-term exposure to air pollution was estimated through annual pollutant concentrations at the residential address over the last two years. Short-term variations in air pollutants and weather parameters were also examined through a 20-day period before the confirmed PCR diagnostic of COVID-19. We found positive associations for diabetes and COVID-19 mortality (OR 2.2 CI 95%: 1.1, 4.4). Regarding environmental factors, we found no association between COVID-19 mortality and air pollutants and weather parameters;however, our study suffers from strong disparities—such as patient characteristics—between fairly polluted and less polluted cities. In order to overcome those disparities between cities, we aimed to explore the relationship between air pollution and COVID-19 mortality within each city, but even with the high-efficiency modelisation systems, differences in air pollutants were too small to estimate the effect of air pollution at the city level. Thus, this study highlights the need to improve the estimation of individual exposure to air pollution. To address this issue, solutions exist such as the increase of the number of fixed air monitors, or even better, through the use of individual markers of air pollution exposure such as urinary black carbon or passive individual samplers. Furthermore, we underline that outdoor air pollutant concentrations may not be representative of individual exposure, especially in the elderly, thus, we suggest that further studies focus on indoor air pollution. Regarding meteorological conditions, we found no association between UV, temperature, wind speed and COVID-19 mortality. We found a positive association bet

关键词： COVID-19 Mortality Air Pollution Particulate Matter Ultraviolet Radiation Temperature

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