The Social and Natural Environment’s Impact on SARS-CoV-2 Infections in the UK Biobank

Abstract

COVID-19 has caused a global pandemic with considerable impact. Studies have examined the influence of socioeconomic status and air pollution on COVID-19 risk but in low detail. This study seeks to further elucidate the nuances of socioeconomic status, as defined by the Index of Multiple Deprivation (IMD), air pollution, and their relationship. We examined the effect of IMD and air pollution on the likelihood of testing positive for SARS-CoV-2 among 66,732 UKB participants tested for SARS-CoV-2 from 16 March 2020 through 16 March 2021. Logistic regression was performed controlling for age, sex, ancestry and IMD or air pollution in the respective models. IMD and its sub-scores were significantly associated with increased risk of testing positive for SARS-CoV-2. All particulate matter less than 2.5 μm (PM2.5), nitrogen oxide (NOx), and nitrogen dioxide (NO2) levels were associated with increased likelihood of testing positive for SARS-CoV-2. Measures of green space and natural environment around participants’ homes were associated with reduced likelihood of SARS-CoV-2. Socioeconomic status and air pollution have independent effects on the risk of testing positive for SARS-CoV-2. Green space and natural environment space in the proximity of people’s homes may mediate the effect of air pollution on the risk of testing positive for SARS-CoV-2.

Particulate matter air pollution and COVID-19 infection, severity, and mortality: A systematic review

“…Some studies reported resolutions up to 100m 2 (28,31), others used entire cities (29) or monitoring stations spaced tens of kilometres apart (32,37). Several did not specify PM 2.5 resolution.…”

“…While this sample is large at around 500,000 people, it is not considered representative of the UK population due to low participation rates and a skew towards older persons (38,39). Additionally, three used PM 2.5 estimates from 2010 (24,27,31) – a decade old – and all used participant residences from 2006-2010. This does not account for change of address or the steady decline in PM 2.5 in the interim (40).…”

“…Of the remaining 14, three did not adjust for any socioeconomic factors. Three of the seven infection studies only included participants with a COVID-19 test (24,31,33), while the remainder either used entire cohorts regardless of whether there was a record of a COVID-19 test (32,34) or conducted analyses of the entire cohort as well as just those tested (16,28). Similarly, all but one study examining severity (28) and mortality (27) were limited to cohorts who were diagnosed with COVID-19, while three were restricted to patients hospitalised with COVID-19 (17,23,29).…”

“…As these are not designed to account for how independent variables may interact (e.g., as mediators or colliders), the statistical associations are less reliable (36). Some studies reported resolutions up to 100m 2 (28,31), others used entire cities (29) or monitoring stations spaced tens of kilometres apart (32,37). Several did not specify PM2.5 resolution.…”

Severe Acute Respiratory Syndrome and Particulate Matter Exposure: A Systematic Review

“…After removing duplicates, N = 732 were assessed for inclusion (abstract and title review). Finally, 46 original research articles were considered eligible [ 25 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ] Table 1 . Data from screening and extraction is available ( Supplementary Tables S1–S3 ).…”