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Air Pollution Is Associated with COVID-19 Incidence and Mortality in Vienna, Austria

Hans‐Peter HutterCenter for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, AustriaMichael PoteserCenter for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, AustriaHanns MoshammerCenter for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, AustriaKathrin LemmererCenter for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, AustriaMonika MayerInstitute of Meteorology and Climatology, University of Natural Resources and Life Sciences Vienna, 1180 Vienna, AustriaLisbeth WeitensfelderCenter for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, AustriaPeter WallnerCenter for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, AustriaMichael KundiCenter for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria
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We determined the impact of air pollution on COVID-19-related mortality and reported-case incidence, analyzing the correlation of infection case numbers and outcomes with previous-year air pollution data from the populations of 23 Viennese districts. Time at risk started in a district when the first COVID-19 case was diagnosed. High exposure levels were defined as living in a district with an average (year 2019) concentration of nitrogen dioxide (NO2) and/or particulate matter (PM10) higher than the upper quartile (30 and 20 µg/m3, respectively) of all districts. The total population of the individual districts was followed until diagnosis of or death from COVID-19, or until 21 April 2020, whichever came first. Cox proportional hazard regression was performed after controlling for percentage of population aged 65 and more, percentage of foreigners and of persons with a university degree, unemployment rate, and population density. PM10 and NO2 were significantly and positively associated with the risk of a COVID-19 diagnosis (hazard ratio (HR) = 1.44 and 1.16, respectively). NO2 was also significantly associated with death from COVID-19 (HR = 1.72). Even within a single city, higher levels of air pollution are associated with an adverse impact on COVID-19 risk.

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