Long-Term Exposure to PM10 Above WHO Guidelines Exacerbates COVID-19 Severity and Mortality

Abstract A retrospective observational study with patients suffering COVID-19 was performed to assess the underlying effect of long-term exposure to NO2 and PM10 on the COVID-19 outcomes. We built multivariate predictive models to assess the relationship between the long-term exposure to NO2 and PM10 and COVID-19 outcomes. The probability of either death or severe COVID-19 outcome and the percentage of dead or severe patients were predicted, while odds ratios and effects estimates were calculated. Whilst the long-term exposure to NO2 is a variable with a rather low importance in the prediction of COVID-19 health outcomes, the long-term exposure to PM10 is a more important variable than some stated comorbidities. PM10 showed the highest effects estimates (1.65, 95% CI 1.32-2.06) on COVID-19 severity. For mortality, the highest effect estimates corresponded to age (3.59, 95% CI 2.94-4.40), followed by PM10 (2.37, 95% CI 1.71-3.32). Finally, an increase of 1 µg/m3 in PM10 concentration causes an increase of 3.06% (95% CI 1.11%-4.25%) and 2.68% (95% CI 0.53%-5.58%) of patients suffering COVID-19 as a severe disease and deaths, respectively. These results demonstrate that long-term PM10 burdens above WHO guidelines exacerbate COVID-19 outcomes, while it must be considered for an accurate medical prognosis of COVID-19.