Short-term association between COVID-19 related deaths, hospitalized patients and air pollution during the first lockdown in the four largest cities in Germany

Abstract

ABSTRACT Identifying risk factors of coronavirus disease 2019 (COVID-19) for its clinical course became important during the current global health crisis. This study explores the relationship between ambient air quality and the clinical course of COVID-19 during the first German lockdown. Daily air pollutant concentrations (PM10, O3 and NO2) and confirmed COVID-19-related hospital cases and deaths in the four largest German cities are used for multivariate regression analysis to study the correlation of air pollutants with COVID-19-related hospitalised or ICU patients and deaths. A significant positive association of O3 with patients and deaths is observed. NO2 shows a positive correlation with hospitalised and ICU patients. A 10 µg/m3 increase in O3 is linked to a 27% (95% CI: 15% to 39%) increase of COVID-19-related deaths. However, PM10 is associated with a decrease in deaths. Altogether, these findings indicate that air pollutants seem to have a significant influence on the course of COVID-19 infections.