The work, which was presented at the Euroanaesthesia conference, gives new urgency to engineering efforts to cut down on air pollution from transportation and manufacturing. The study, by Dr Susanne Koch and colleagues from the Department of Anaesthesiology & Intensive Care, Charité at Universitätsmedizin Berlin, found that people living in German counties with higher levels of the pollutant nitrogen dioxide were more likely to require intensive care and mechanical ventilation if they caught covid.
NO2, which is released when fossil fuels are burned, has been found to have harmful effects on the lungs, including damage to the endothelial cells, which play a key role in the transfer of oxygen into the blood.
The study used air pollution data from between 2009 and 2019 to calculate the average level of NO2 for each county in Germany, with the highest level in Frankfurt. That was then compared with the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) registry, which was set up to monitor ICU capacity during the pandemic.
Each 1 µg/m³ increase in long-term annual mean NO2 concentration was associated with a 3.2% increase in the number of ICU beds occupied by COVID-19 patients and a 3.5% increase in the number of COVID-19 patients who needed mechanical ventilation.
On average, 28 ICU beds and 19 ventilators were needed for COVID-19 patients in each of the ten counties with the lowest long-term NO2 exposure, during the month studied. This compares to an average of 144 ICU beds and 102 ventilators in the ten counties with the highest long-term NO2 exposure.
“Long-term exposure to NO2 long before the pandemic may have made people more vulnerable to more severe COVID-19 disease," said Koch.
“Exposure to ambient air pollution can contribute to a range of other conditions, including heart attacks, strokes, asthma and lung cancer, and will continue to harm health long after the COVID-19 pandemic ends.
“A transition to renewable energy, clean transportation and sustainable agriculture is urgently needed to improve air quality. Reducing emissions won’t just help to limit climate crisis, it will improve the health and the quality of life of people around the world.”
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