Associations of COVID-19 Hospitalizations, ICU Admissions, and Mortality with Black and White Race and Their Mediation by Air Pollution and Other Risk Factors in the Louisiana Industrial Corridor, March 2020–August 2021

Louisiana ranks among the bottom five states for air pollution and mortality. Our objective was to investigate associations between race and Coronavirus Disease 2019 (COVID-19) hospitalizations, intensive care unit (ICU) admissions, and mortality over time and determine which air pollutants and other characteristics may mediate COVID-19-associated outcomes. In our cross-sectional study, we analyzed hospitalizations, ICU admissions, and mortality among positive SARS-CoV-2 cases within a healthcare system around the Louisiana Industrial Corridor over four waves of the pandemic from 1 March 2020 to 31 August 2021. Associations between race and each outcome were tested, and multiple mediation analysis was performed to test if other demographic, socioeconomic, or air pollution variables mediate the race–outcome relationships after adjusting for all available confounders. Race was associated with each outcome over the study duration and during most waves. Early in the pandemic, hospitalization, ICU admission, and mortality rates were greater among Black patients, but as the pandemic progressed, these rates became greater in White patients. However, Black patients were disproportionately represented in these measures. Our findings imply that air pollution might contribute to the disproportionate share of COVID-19 hospitalizations and mortality among Black residents in Louisiana.

Associations of COVID-19 Hospitalizations, ICU Admissions, and Mortality with Black and White Race and Their Mediation by Air Pollution and Other Risk Factors in the Louisiana Industrial Corridor, March 2020-August 2021.

Louisiana ranks among the bottom five states for air pollution and mortality. Our objective was to investigate associations between race and Coronavirus Disease 2019 (COVID-19) hospitalizations, intensive care unit (ICU) admissions, and mortality over time and determine which air pollutants and other characteristics may mediate COVID-19-associated outcomes. In our cross-sectional study, we analyzed hospitalizations, ICU admissions, and mortality among positive SARS-CoV-2 cases within a healthcare system around the Louisiana Industrial Corridor over four waves of the pandemic from 1 March 2020 to 31 August 2021. Associations between race and each outcome were tested, and multiple mediation analysis was performed to test if other demographic, socioeconomic, or air pollution variables mediate the race-outcome relationships after adjusting for all available confounders. Race was associated with each outcome over the study duration and during most waves. Early in the pandemic, hospitalization, ICU admission, and mortality rates were greater among Black patients, but as the pandemic progressed, these rates became greater in White patients. However, Black patients were disproportionately represented in these measures. Our findings imply that air pollution might contribute to the disproportionate share of COVID-19 hospitalizations and mortality among Black residents in Louisiana.

Spatial associations of long-term exposure to diesel particulate matter with seasonal and annual mortality due to COVID-19 in the contiguous United States.

BACKGROUND: People with certain underlying respiratory and cardiovascular conditions might be at an increased risk for severe illness from COVID-19. Diesel Particulate Matter (DPM) exposure may affect the pulmonary and cardiovascular systems. The study aims to assess if DPM was spatially associated with COVID-19 mortality rates across three waves of the disease and throughout 2020. METHODS: We tested an ordinary least squares (OLS) model, then two global models, a spatial lag model (SLM) and a spatial error model (SEM) designed to explore spatial dependence, and a geographically weighted regression (GWR) model designed to explore local associations between COVID-19 mortality rates and DPM exposure, using data from the 2018 AirToxScreen database. RESULTS: The GWR model found that associations between COVID-19 mortality rate and DPM concentrations may increase up to 77 deaths per 100,000 people in some US counties for every interquartile range (0.21 µg/m3) increase in DPM concentration. Significant positive associations between mortality rate and DPM were observed in New York, New Jersey, eastern Pennsylvania, and western Connecticut for the wave from January to May, and in southern Florida and southern Texas for June to September. The period from October to December exhibited a negative association in most parts of the US, which seems to have influenced the year-long relationship due to the large number of deaths during that wave of the disease. CONCLUSIONS: Our models provided a picture in which long-term DPM exposure may have influenced COVID-19 mortality during the early stages of the disease. That influence appears to have waned over time as transmission patterns evolved.