Modulation of COVID-19 incidence by environmental stressors is variant between pre-Omicron and Omicron periods

Abstract COVID-19 had a devastating impact on humanity. We investigated how residential air pollution (ozone (O3), nitrogen dioxide (NO2), fine particulate matter (PM2.5)) and meteorological factors (temperature (Temp), precipitation (Prec)) are associated with COVID-19 incidence in Baden-Württember...

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Main Authors: Leona Hoffmann, Lorenza Gilardi, Tobias Antoni, Maxana Baltruweit, Michael Bittner, Susanne Breitner, Simon Dally, Thilo Erbertseder, Sabine Hawighorst-Knapstein, Marie-Therese Schmitz, Rochelle Schneider, Sabine Wüst, Jörn Rittweger
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-025-13521-2
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author Leona Hoffmann
Lorenza Gilardi
Tobias Antoni
Maxana Baltruweit
Michael Bittner
Susanne Breitner
Simon Dally
Thilo Erbertseder
Sabine Hawighorst-Knapstein
Marie-Therese Schmitz
Rochelle Schneider
Sabine Wüst
Jörn Rittweger
author_facet Leona Hoffmann
Lorenza Gilardi
Tobias Antoni
Maxana Baltruweit
Michael Bittner
Susanne Breitner
Simon Dally
Thilo Erbertseder
Sabine Hawighorst-Knapstein
Marie-Therese Schmitz
Rochelle Schneider
Sabine Wüst
Jörn Rittweger
author_sort Leona Hoffmann
collection DOAJ
description Abstract COVID-19 had a devastating impact on humanity. We investigated how residential air pollution (ozone (O3), nitrogen dioxide (NO2), fine particulate matter (PM2.5)) and meteorological factors (temperature (Temp), precipitation (Prec)) are associated with COVID-19 incidence in Baden-Württemberg (BW), Germany. We utilized data from the Copernicus Atmosphere Monitoring Service and the Copernicus Climate Change Service to model environmental exposure from 2020 to 2022 in postal code areas in BW. Health insurance data on SARS-CoV-2 infections were provided from the health insurance AOK BW on a quarterly level covering approximately 12 million person-years. We examined the spatiotemporal variability with a generalized additive model including various stressors, demographic factors, and area-wide data, offering a comprehensive analysis of the environmental stressor- COVI-10 incidence associations. In 2022, during the prevalence of the Omicron variant, the number of COVID-19 cases tripled compared to 2020. During the pre-Omicron period, COVID-19 incidence showed a positive association with PM2.5 (relative risk [RR] 2.41; 95% confidence interval [CI] (2.31, 2.52)), a negative association with Temp (RR 0.39 (0.32, 0.48)), and no clear or slight associations with O3, Prec, and NO2. During the Omicron period, there were either no clear or slight negative associations with Temp (RR 0.92 (0.74, 1.30)), PM2·5 (RR 0.70 (0.64, 0.79)), NO2, and Prec and a negative association with O3 (RR 0.46 (0.40, 0.53)). The analysis found clear links between environmental stressors and COVID-19 incidence, which strongly differed between pre-Omicron and Omicron periods. Consideration of environmental stressor concentration could be relevant in the management of the pandemic.
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spelling doaj-art-0466eeb7ec8b424b8796c45e6936c6e72025-08-20T03:43:11ZengNature PortfolioScientific Reports2045-23222025-07-0115111210.1038/s41598-025-13521-2Modulation of COVID-19 incidence by environmental stressors is variant between pre-Omicron and Omicron periodsLeona Hoffmann0Lorenza Gilardi1Tobias Antoni2Maxana Baltruweit3Michael Bittner4Susanne Breitner5Simon Dally6Thilo Erbertseder7Sabine Hawighorst-Knapstein8Marie-Therese Schmitz9Rochelle Schneider10Sabine Wüst11Jörn Rittweger12Institute of Aerospace Medicine, German Aerospace Center (DLR)German Remote Sensing Data Center, German Aerospace Center (DLR)Allgemeine Ortskrankenkasse Baden-Württemberg (AOK-BW)Allgemeine Ortskrankenkasse Baden-Württemberg (AOK-BW)German Remote Sensing Data Center, German Aerospace Center (DLR)Institute of Epidemiology, Helmholtz Zentrum München - German Research Centre for Environmental HealthAllgemeine Ortskrankenkasse Baden-Württemberg (AOK-BW)German Remote Sensing Data Center, German Aerospace Center (DLR)Allgemeine Ortskrankenkasse Baden-Württemberg (AOK-BW)Institute of Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital BonnΦ-Lab, European Space Agency (ESA)German Remote Sensing Data Center, German Aerospace Center (DLR)Institute of Aerospace Medicine, German Aerospace Center (DLR)Abstract COVID-19 had a devastating impact on humanity. We investigated how residential air pollution (ozone (O3), nitrogen dioxide (NO2), fine particulate matter (PM2.5)) and meteorological factors (temperature (Temp), precipitation (Prec)) are associated with COVID-19 incidence in Baden-Württemberg (BW), Germany. We utilized data from the Copernicus Atmosphere Monitoring Service and the Copernicus Climate Change Service to model environmental exposure from 2020 to 2022 in postal code areas in BW. Health insurance data on SARS-CoV-2 infections were provided from the health insurance AOK BW on a quarterly level covering approximately 12 million person-years. We examined the spatiotemporal variability with a generalized additive model including various stressors, demographic factors, and area-wide data, offering a comprehensive analysis of the environmental stressor- COVI-10 incidence associations. In 2022, during the prevalence of the Omicron variant, the number of COVID-19 cases tripled compared to 2020. During the pre-Omicron period, COVID-19 incidence showed a positive association with PM2.5 (relative risk [RR] 2.41; 95% confidence interval [CI] (2.31, 2.52)), a negative association with Temp (RR 0.39 (0.32, 0.48)), and no clear or slight associations with O3, Prec, and NO2. During the Omicron period, there were either no clear or slight negative associations with Temp (RR 0.92 (0.74, 1.30)), PM2·5 (RR 0.70 (0.64, 0.79)), NO2, and Prec and a negative association with O3 (RR 0.46 (0.40, 0.53)). The analysis found clear links between environmental stressors and COVID-19 incidence, which strongly differed between pre-Omicron and Omicron periods. Consideration of environmental stressor concentration could be relevant in the management of the pandemic.https://doi.org/10.1038/s41598-025-13521-2
spellingShingle Leona Hoffmann
Lorenza Gilardi
Tobias Antoni
Maxana Baltruweit
Michael Bittner
Susanne Breitner
Simon Dally
Thilo Erbertseder
Sabine Hawighorst-Knapstein
Marie-Therese Schmitz
Rochelle Schneider
Sabine Wüst
Jörn Rittweger
Modulation of COVID-19 incidence by environmental stressors is variant between pre-Omicron and Omicron periods
Scientific Reports
title Modulation of COVID-19 incidence by environmental stressors is variant between pre-Omicron and Omicron periods
title_full Modulation of COVID-19 incidence by environmental stressors is variant between pre-Omicron and Omicron periods
title_fullStr Modulation of COVID-19 incidence by environmental stressors is variant between pre-Omicron and Omicron periods
title_full_unstemmed Modulation of COVID-19 incidence by environmental stressors is variant between pre-Omicron and Omicron periods
title_short Modulation of COVID-19 incidence by environmental stressors is variant between pre-Omicron and Omicron periods
title_sort modulation of covid 19 incidence by environmental stressors is variant between pre omicron and omicron periods
url https://doi.org/10.1038/s41598-025-13521-2
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