Effects of short-term and long-term exposure to ambient air pollution and temperature on long recovery duration in COVID-19 patients

The novel coronavirus disease 2019 (COVID-19) has spread rapidly around the world since December 8, 2019. However, the key factors affecting the duration of recovery from COVID-19 remain unclear. To investigate the associations of long recovery duration of COVID-19 patients with ambient air pollution, temperature, and diurnal temperature range (DTR) exposure. A total of 427 confirmed cases in Changsha during the first wave of the epidemic in January 2020 were selected. We used inverse distance weighting (IDW) method to estimate personal exposure to seven ambient air pollutants (PM2.5, PM2.5-10, PM10, SO2, NO2, CO, and O3) at each subject's home address. Meteorological conditions included temperature and DTR. Multiple logistic regression model was used to investigate the relationship of air pollution exposure during short-term (past week and past month) and long-term (past three months) with recovery duration among COVID-19 patients. We found that long recovery duration among COVID-19 patients was positively associated with short-term exposure to CO during past week with OR (95% CI) = 1.42 (1.01–2.00) and PM2.5, NO2, and CO during past month with ORs (95% CI) = 2.00 (1.30–3.07) and 1.95 (1.30–2.93), and was negatively related with short-term exposure to O3 during past week and past month with ORs (95% CI) = 0.68 (0.46–0.99) and 0.41 (0.27–0.62), respectively. No association was observed for long-term exposure to air pollution during past three months. Furthermore, increased temperature during past three months elevated risk of long recovery duration in VOCID-19 patients, while DTR exposure during past week and past month decreased the risk. Male and younger patients were more susceptible to the effect of air pollution on long recovery duration, while female and older patients were more affected by exposure to temperature and DTR. Our findings suggest that both TRAP exposure and temperature indicators play important roles in prolonged recovery among COVID-19 patients, especially for the sensitive populations, which provide potential strategies for effective reduction and early prevention of long recovery duration of COVID-19. [Display omitted] •Short-term exposure to CO and NO2 was associated with prolonged recovery of COVID-19.•Long-term and short-term exposure to PM2.5 was related with risk of prolonged COVID-19 recovery.•High temperature and low diurnal temperature range increased duration of COVID-19 recovery.•Traffic-related air pollution (TRAP) and tem