Ambient air pollution exposure linked to long COVID among young adults: a nested survey in a population-based cohort in Sweden

Post COVID-19 conditions, also known as long COVID, are of public health concern, but little is known about their underlying risk factors. We aimed to investigate associations of air pollution exposure with long COVID among Swedish young adults. We used data from the BAMSE (Children, Allergy, Enviro...

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Veröffentlicht in:The Lancet regional health. Europe 2023-05, Vol.28, p.100608-100608, Article 100608
Hauptverfasser: Yu, Zhebin, Ekström, Sandra, Bellander, Tom, Ljungman, Petter, Pershagen, Göran, Eneroth, Kristina, Kull, Inger, Bergström, Anna, Georgelis, Antonios, Stafoggia, Massimo, Gruzieva, Olena, Melén, Erik, Almqvist, Catarina, Andersson, Niklas, Ballardini, Natalia, Björkander, Sophia, Brodin, Petter, Castel, Anna, Hammarström, Lennart, Pan-Hammarström, Qiang, Hallberg, Jenny, Jansson, Christer, Kere, Maura, Lauber, André, Lövquist, Alexandra, Mjösberg, Jenny, Mogensen, Ida, Palmberg, Lena, Roxhed, Niclas, Schwenk, Jochen
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container_title The Lancet regional health. Europe
container_volume 28
creator Yu, Zhebin
Ekström, Sandra
Bellander, Tom
Ljungman, Petter
Pershagen, Göran
Eneroth, Kristina
Kull, Inger
Bergström, Anna
Georgelis, Antonios
Stafoggia, Massimo
Gruzieva, Olena
Melén, Erik
Almqvist, Catarina
Andersson, Niklas
Ballardini, Natalia
Bergström, Anna
Björkander, Sophia
Brodin, Petter
Castel, Anna
Ekström, Sandra
Georgelis, Antonios
Hammarström, Lennart
Pan-Hammarström, Qiang
Hallberg, Jenny
Jansson, Christer
Kere, Maura
Kull, Inger
Lauber, André
Lövquist, Alexandra
Melén, Erik
Mjösberg, Jenny
Mogensen, Ida
Palmberg, Lena
Pershagen, Göran
Roxhed, Niclas
Schwenk, Jochen
description Post COVID-19 conditions, also known as long COVID, are of public health concern, but little is known about their underlying risk factors. We aimed to investigate associations of air pollution exposure with long COVID among Swedish young adults. We used data from the BAMSE (Children, Allergy, Environment, Stockholm, Epidemiology [in Swedish]) cohort. From October 2021 to February 2022 participants answered a web-questionnaire focusing on persistent symptoms following acute SARS-CoV-2 infection. Long COVID was defined as symptoms after confirmed infection with SARS-CoV-2 lasting for two months or longer. Ambient air pollution levels (particulate matter ≤2.5 μm [PM2.5], ≤10 μm [PM10], black carbon [BC] and nitrogen oxides [NOx]) at individual-level addresses were estimated using dispersion modelling. A total of 753 participants with SARS-CoV-2 infection were included of whom 116 (15.4%) reported having long COVID. The most common symptoms were altered smell/taste (n = 80, 10.6%), dyspnea (n = 36, 4.8%) and fatigue (n = 34, 4.5%). Median annual PM2.5 exposure in 2019 (pre-pandemic) was 6.39 (interquartile range [IQR] 6.06–6.71) μg/m3. Adjusted Odds Ratios (95% confidence intervals) of PM2.5 per IQR increase were 1.28 (1.02–1.60) for long COVID, 1.65 (1.09–2.50) for dyspnea symptoms and 1.29 (0.97–1.70) for altered smell/taste. Positive associations were found for the other air pollutants and remained consistent across sensitivity analyses. Associations tended to be stronger among participants with asthma, and those having had COVID during 2020 (versus 2021). Ambient long-term PM2.5 exposure may affect the risk of long COVID in young adults, supporting efforts for continuously improving air quality. The study received funding from the Swedish Research Council (grant no. 2020-01886, 2022-06340), the Swedish Research Council for Health, Working life and Welfare (FORTE grant no. 2017-01146), the Swedish Heart-Lung Foundation, Karolinska Institute (no. 2022-01807) and Region Stockholm (ALF project for cohort and database maintenance).
doi_str_mv 10.1016/j.lanepe.2023.100608
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We aimed to investigate associations of air pollution exposure with long COVID among Swedish young adults. We used data from the BAMSE (Children, Allergy, Environment, Stockholm, Epidemiology [in Swedish]) cohort. From October 2021 to February 2022 participants answered a web-questionnaire focusing on persistent symptoms following acute SARS-CoV-2 infection. Long COVID was defined as symptoms after confirmed infection with SARS-CoV-2 lasting for two months or longer. Ambient air pollution levels (particulate matter ≤2.5 μm [PM2.5], ≤10 μm [PM10], black carbon [BC] and nitrogen oxides [NOx]) at individual-level addresses were estimated using dispersion modelling. A total of 753 participants with SARS-CoV-2 infection were included of whom 116 (15.4%) reported having long COVID. The most common symptoms were altered smell/taste (n = 80, 10.6%), dyspnea (n = 36, 4.8%) and fatigue (n = 34, 4.5%). Median annual PM2.5 exposure in 2019 (pre-pandemic) was 6.39 (interquartile range [IQR] 6.06–6.71) μg/m3. Adjusted Odds Ratios (95% confidence intervals) of PM2.5 per IQR increase were 1.28 (1.02–1.60) for long COVID, 1.65 (1.09–2.50) for dyspnea symptoms and 1.29 (0.97–1.70) for altered smell/taste. Positive associations were found for the other air pollutants and remained consistent across sensitivity analyses. Associations tended to be stronger among participants with asthma, and those having had COVID during 2020 (versus 2021). Ambient long-term PM2.5 exposure may affect the risk of long COVID in young adults, supporting efforts for continuously improving air quality. The study received funding from the Swedish Research Council (grant no. 2020-01886, 2022-06340), the Swedish Research Council for Health, Working life and Welfare (FORTE grant no. 2017-01146), the Swedish Heart-Lung Foundation, Karolinska Institute (no. 2022-01807) and Region Stockholm (ALF project for cohort and database maintenance).</description><identifier>ISSN: 2666-7762</identifier><identifier>EISSN: 2666-7762</identifier><identifier>DOI: 10.1016/j.lanepe.2023.100608</identifier><identifier>PMID: 37131862</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Air pollution ; Long COVID ; PM2.5 ; Young adults</subject><ispartof>The Lancet regional health. 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Europe</title><addtitle>Lancet Reg Health Eur</addtitle><description>Post COVID-19 conditions, also known as long COVID, are of public health concern, but little is known about their underlying risk factors. We aimed to investigate associations of air pollution exposure with long COVID among Swedish young adults. We used data from the BAMSE (Children, Allergy, Environment, Stockholm, Epidemiology [in Swedish]) cohort. From October 2021 to February 2022 participants answered a web-questionnaire focusing on persistent symptoms following acute SARS-CoV-2 infection. Long COVID was defined as symptoms after confirmed infection with SARS-CoV-2 lasting for two months or longer. Ambient air pollution levels (particulate matter ≤2.5 μm [PM2.5], ≤10 μm [PM10], black carbon [BC] and nitrogen oxides [NOx]) at individual-level addresses were estimated using dispersion modelling. A total of 753 participants with SARS-CoV-2 infection were included of whom 116 (15.4%) reported having long COVID. The most common symptoms were altered smell/taste (n = 80, 10.6%), dyspnea (n = 36, 4.8%) and fatigue (n = 34, 4.5%). Median annual PM2.5 exposure in 2019 (pre-pandemic) was 6.39 (interquartile range [IQR] 6.06–6.71) μg/m3. Adjusted Odds Ratios (95% confidence intervals) of PM2.5 per IQR increase were 1.28 (1.02–1.60) for long COVID, 1.65 (1.09–2.50) for dyspnea symptoms and 1.29 (0.97–1.70) for altered smell/taste. Positive associations were found for the other air pollutants and remained consistent across sensitivity analyses. Associations tended to be stronger among participants with asthma, and those having had COVID during 2020 (versus 2021). Ambient long-term PM2.5 exposure may affect the risk of long COVID in young adults, supporting efforts for continuously improving air quality. The study received funding from the Swedish Research Council (grant no. 2020-01886, 2022-06340), the Swedish Research Council for Health, Working life and Welfare (FORTE grant no. 2017-01146), the Swedish Heart-Lung Foundation, Karolinska Institute (no. 2022-01807) and Region Stockholm (ALF project for cohort and database maintenance).</description><subject>Air pollution</subject><subject>Long COVID</subject><subject>PM2.5</subject><subject>Young adults</subject><issn>2666-7762</issn><issn>2666-7762</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>D8T</sourceid><recordid>eNp9Uc1u1DAQjhAVrdq-AUI-csliO4ljc0CqtvxUqtRDgavl2JPWWycOdrJlT7wKz8KT4Sjb0l642KP5fsaeL8teE7wimLB3m5VTPQywopgWqYUZ5i-yI8oYy-ua0ZdP6sPsNMYNxphWpKCkfJUdFjUpCGf0KPt11jUW-hEpG9DgnZtG63sEPwcfpwDI2f4ODBo9cr6_Qeur7xfnSHVzvfNTOpWZ3BjfI4V6iGOiJtkWdsj2qTX4YXJqdswbFROo_a0PYwL__L6-BwP9SXbQKhfhdH8fZ98-ffy6_pJfXn2-WJ9d5rrCZMxBlJqD5hxaXpjCYNXguqkNFrQpBGGqbQ2n1CiuMZQaGk1Y1VSEi5prLkhxnOWLb7yHYWrkEGynwk56ZeW-dZcqkGXJSD3zPyz8hHRgdFpRUO6Z7DnS21t547dSCC6YYMng7d4g-B9TWo3sbNTg5tz8FCXlWKTYKjJTy4Wqg48xQPs4hmA5xy03colbznHLJe4ke_P0iY-ih3D__QHSYrcWgow6Za3B2AB6lMbb_0_4C83ewbY</recordid><startdate>20230501</startdate><enddate>20230501</enddate><creator>Yu, Zhebin</creator><creator>Ekström, Sandra</creator><creator>Bellander, Tom</creator><creator>Ljungman, Petter</creator><creator>Pershagen, Göran</creator><creator>Eneroth, Kristina</creator><creator>Kull, Inger</creator><creator>Bergström, Anna</creator><creator>Georgelis, Antonios</creator><creator>Stafoggia, Massimo</creator><creator>Gruzieva, Olena</creator><creator>Melén, Erik</creator><creator>Almqvist, Catarina</creator><creator>Andersson, Niklas</creator><creator>Ballardini, Natalia</creator><creator>Bergström, Anna</creator><creator>Björkander, Sophia</creator><creator>Brodin, Petter</creator><creator>Castel, Anna</creator><creator>Ekström, Sandra</creator><creator>Georgelis, Antonios</creator><creator>Hammarström, Lennart</creator><creator>Pan-Hammarström, Qiang</creator><creator>Hallberg, Jenny</creator><creator>Jansson, Christer</creator><creator>Kere, Maura</creator><creator>Kull, Inger</creator><creator>Lauber, André</creator><creator>Lövquist, Alexandra</creator><creator>Melén, Erik</creator><creator>Mjösberg, Jenny</creator><creator>Mogensen, Ida</creator><creator>Palmberg, Lena</creator><creator>Pershagen, Göran</creator><creator>Roxhed, Niclas</creator><creator>Schwenk, Jochen</creator><general>Elsevier Ltd</general><general>The Author(s). 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Europe</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yu, Zhebin</au><au>Ekström, Sandra</au><au>Bellander, Tom</au><au>Ljungman, Petter</au><au>Pershagen, Göran</au><au>Eneroth, Kristina</au><au>Kull, Inger</au><au>Bergström, Anna</au><au>Georgelis, Antonios</au><au>Stafoggia, Massimo</au><au>Gruzieva, Olena</au><au>Melén, Erik</au><au>Almqvist, Catarina</au><au>Andersson, Niklas</au><au>Ballardini, Natalia</au><au>Bergström, Anna</au><au>Björkander, Sophia</au><au>Brodin, Petter</au><au>Castel, Anna</au><au>Ekström, Sandra</au><au>Georgelis, Antonios</au><au>Hammarström, Lennart</au><au>Pan-Hammarström, Qiang</au><au>Hallberg, Jenny</au><au>Jansson, Christer</au><au>Kere, Maura</au><au>Kull, Inger</au><au>Lauber, André</au><au>Lövquist, Alexandra</au><au>Melén, Erik</au><au>Mjösberg, Jenny</au><au>Mogensen, Ida</au><au>Palmberg, Lena</au><au>Pershagen, Göran</au><au>Roxhed, Niclas</au><au>Schwenk, Jochen</au><aucorp>the BAMSE COVID-19 Study Group</aucorp><aucorp>BAMSE COVID-19 Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ambient air pollution exposure linked to long COVID among young adults: a nested survey in a population-based cohort in Sweden</atitle><jtitle>The Lancet regional health. Europe</jtitle><addtitle>Lancet Reg Health Eur</addtitle><date>2023-05-01</date><risdate>2023</risdate><volume>28</volume><spage>100608</spage><epage>100608</epage><pages>100608-100608</pages><artnum>100608</artnum><issn>2666-7762</issn><eissn>2666-7762</eissn><abstract>Post COVID-19 conditions, also known as long COVID, are of public health concern, but little is known about their underlying risk factors. We aimed to investigate associations of air pollution exposure with long COVID among Swedish young adults. We used data from the BAMSE (Children, Allergy, Environment, Stockholm, Epidemiology [in Swedish]) cohort. From October 2021 to February 2022 participants answered a web-questionnaire focusing on persistent symptoms following acute SARS-CoV-2 infection. Long COVID was defined as symptoms after confirmed infection with SARS-CoV-2 lasting for two months or longer. Ambient air pollution levels (particulate matter ≤2.5 μm [PM2.5], ≤10 μm [PM10], black carbon [BC] and nitrogen oxides [NOx]) at individual-level addresses were estimated using dispersion modelling. A total of 753 participants with SARS-CoV-2 infection were included of whom 116 (15.4%) reported having long COVID. The most common symptoms were altered smell/taste (n = 80, 10.6%), dyspnea (n = 36, 4.8%) and fatigue (n = 34, 4.5%). Median annual PM2.5 exposure in 2019 (pre-pandemic) was 6.39 (interquartile range [IQR] 6.06–6.71) μg/m3. Adjusted Odds Ratios (95% confidence intervals) of PM2.5 per IQR increase were 1.28 (1.02–1.60) for long COVID, 1.65 (1.09–2.50) for dyspnea symptoms and 1.29 (0.97–1.70) for altered smell/taste. Positive associations were found for the other air pollutants and remained consistent across sensitivity analyses. Associations tended to be stronger among participants with asthma, and those having had COVID during 2020 (versus 2021). Ambient long-term PM2.5 exposure may affect the risk of long COVID in young adults, supporting efforts for continuously improving air quality. The study received funding from the Swedish Research Council (grant no. 2020-01886, 2022-06340), the Swedish Research Council for Health, Working life and Welfare (FORTE grant no. 2017-01146), the Swedish Heart-Lung Foundation, Karolinska Institute (no. 2022-01807) and Region Stockholm (ALF project for cohort and database maintenance).</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>37131862</pmid><doi>10.1016/j.lanepe.2023.100608</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0001-9392-5624</orcidid><orcidid>https://orcid.org/0000-0002-0657-1512</orcidid><oa>free_for_read</oa></addata></record>
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subjects Air pollution
Long COVID
PM2.5
Young adults
title Ambient air pollution exposure linked to long COVID among young adults: a nested survey in a population-based cohort in Sweden
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