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Proc Natl Acad Sci U S A . Independent and combined effects of long-term air pollution exposure and genetic predisposition on COVID-19 severity: A

tetano

Editor, Senior Moderator
Proc Natl Acad Sci U S A


. 2025 Mar 11;122(10):e2421513122.
doi: 10.1073/pnas.2421513122. Epub 2025 Mar 3. Independent and combined effects of long-term air pollution exposure and genetic predisposition on COVID-19 severity: A population-based cohort study

Yudiyang Ma[SUP] 1 2 [/SUP], Jianing Wang[SUP] 1 2 [/SUP], Feipeng Cui[SUP] 1 2 [/SUP], Linxi Tang[SUP] 1 2 [/SUP], Sara Khalid[SUP] 3 [/SUP], Yaohua Tian[SUP] 1 2 [/SUP], Junqin Xie[SUP] 4 [/SUP]



Affiliations
Abstract

The relationships between air pollution, genetic susceptibility, and COVID-19-related outcomes, as well as the potential interplays between air pollution and genetic susceptibility, remain largely unexplored. The Cox proportional hazards model was used to assess associations between long-term exposure to air pollutants and the risk of COVID-19 outcomes (infection, hospitalization, and death) in a COVID-19-naive cohort (n = 458,396). Additionally, associations between air pollutants and the risk of COVID-19 severity (hospitalization and death) were evaluated in a COVID-19 infection cohort (n = 110,216). Furthermore, this study investigated the role of host genetic susceptibility in the relationships between exposure to air pollutants and the development of COVID-19-related outcomes. Long-term exposure to air pollutants was significantly associated with an increased risk of COVID-19-related outcomes in the COVID-19 naive cohort. Similarly, in COVID-19 infection cohort, hazard ratios (HRs) for COVID-19 hospital admission were 1.23 (1.19, 1.27) for PM[SUB]2.5[/SUB] and 1.22 (1.17, 1.26) for PM[SUB]10[/SUB], whereas HRs for COVID-19 death were 1.28 (1.18, 1.39) for PM[SUB]2.5[/SUB] and 1.25 (1.16, 1.36) for PM[SUB]10[/SUB]. Notably, significant interactions were found between PM[SUB]2.5[/SUB]/PM[SUB]10[/SUB] and genetic susceptibility in COVID-19 death. In COVID-19 infection cohort, participants with both high genetic risk and high air pollutants exposure had 1.86- to 1.97-fold and 1.91- to 2.14-fold higher risk of COVID-19 hospitalization and death compared to those with both low genetic risk and low air pollutants exposure. Exposure to air pollution is significantly associated with an increased burden of severe COVID-19, and air pollution-gene interactions may play a crucial role in the development of COVID-19-related outcomes.

Keywords: COVID-19; air pollutants; cohort study.

 
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