The joint impact of temperature, humidity, and air pollution on COVID-19 incidence : a multi-country time-series study in 439 cities
Wagatsuma, Keita (Niigata University)
Feurer, Denise (University of Padua)
Yu, Wenhua (Monash University)
Xu, Rongbin (Monash University)
Riffe, Timothy (Universidad del País Vasco)
Kniffka, Maxi Stella (Universität Rostock)
Acosta, Enrique (Centre d'Estudis Demogràfics)
Armstrong, Ben (London School of Hygiene and Tropical Medicine)
Mistry, Malcolm (University of Venice)
Lowe, Rachel (Institució Catalana de Recerca i Estudis Avançats)
Royé, Dominic (Climate Research Foundation (FIC), Madrid)
Hashizume, Masahiro (The University of Tokyo)
Tobías, Aurelio (Nagasaki University)
Vicedo-Cabrerat, Ana Maria (University of Bern)
Madaniyazi, Lina (Nagasaki University)
Sheng Ng, Chris Fook (The University of Tokyo)
Íñiguez, Carmen (Universitat de València)
Ragettli, Martina S. (University of Basel)
Lavigne, Eric (University of Ottawa)
Matus Correa, Patricia (Universidad de los Andes)
Valdés Ortega, Nicolás (Universidad de los Andes)
Kyselý, Jan (Czech University of Life Sciences)
Urban, Aleš (Czech University of Life Sciences)
Orru, Hans (University of Tartu)
Indermitte, Ene (University of Tartu)
Maasikmets, Marek (Estonian Environmental Research Centre)
Breitner-Busch, Susanne (German Research Center for Environmental Health)
Schneider, Alexandra (German Research Center for Environmental Health)
Honda, Yasushi (University of Tsukuba)
Alahmad, Barrak (Harvard University)
Zanobetti, Antonella (Harvard University)
Schwartz, Joel (Harvard University)
Carrasco, Gabriela (Universidad Peruana Cayetano Heredia)
Holobâca, Iulian Horia (Babes-Bolyai University)
Kim, Ho (Seoul National University)
Lee, Whanhee (Pusan National University)
Bell, Michelle L. (Yale University)
Scovronick, Noah (Emory University)
Acquaotta, Fiorella (University of Torino)
de Sousa Zanotti Stagliorio Coélho, Micheline (Universidade de São Paulo)
Hurtado Diaz, Magali (Department of Environmental Health, National Institute of Public Health)
Félix Arellano, Eunice Elizabeth (Department of Environmental Health, National Institute of Public Health)
Michelozzi, Paola (Lazio Regional Health Service)
Stafoggia, Massimo (Lazio Region Health Service)
de'Donato, Francesca (Lazio Region Health Service)
Rao, Shilpa (Norwegian Institute of Public Health)
Seposo, Xerxes (Hokkaido University)
Tong, Shilu (Queensland University of Technology)
Klompmaker, Jochem (National Institute for Public Health and the Environment)
Guo, Yuming (Monash University)
Masselot, Pierre (London School of Hygiene and Tropical Medicine)
Gasparrini, Antonio (London School of Hygiene and Tropical Medicine)
Sera, Francesco (Università degli Studi di Firenze)
Centre d'Estudis Demogràfics
Fundació Institució Catalana de Recerca i Estudis Avançats

Fecha:	2026
Resumen:	Several studies have explored the short-term effects of environmental stressors on coronavirus disease 2019 (COVID-19) transmission and severity. However, evidence on the interactive effects of meteorological conditions and air pollution remains limited and geographically variable. We therefore aimed to quantify the independent and interactive effects of short-term exposure to humidex, a composite index of temperature and relative humidity, and fine particulate matter ≤ 2. 5 μm (PM2. 5) on daily COVID-19 incidence across multiple cities and in multiple countries. Daily time-series data on confirmed COVID-19 cases, meteorological factors, and PM2. 5 concentrations were collected from 439 cities in 22 countries during January 2020-August 2022 as part of the Multi-Country Multi-City Collaborative Research Network. A two-stage design was applied: first, city-specific quasi-Poisson models with distributed lag non-linear models estimated exposure-response associations; second, multilevel random-effects meta-analyses pooled city-specific estimates. Effect modification by PM2. 5 was assessed using a product term between non-linear humidex function and linear PM2. 5 function. Approximately 95. 1 million confirmed COVID-19 cases were analyzed. Lower humidex values (0. 1 ◦C versus 15. 1 ◦C) were associated with increased daily cases (relative risk [RR]: 1. 1192, 95% confidence interval [CI]: 1. 0214-1. 2262). A 10 μg/m3 increase in PM2. 5 over the current and preceding 2 days was associated with a modest increase in daily cases (RR: 1. 0079, 95% CI: 1. 0001-1. 0161). No statistically significant interaction between humidex and PM2. 5 was observed. Short-term exposure to cold-dry conditions and elevated PM2. 5 independently increased COVID-19 incidence, highlighting the need to consider both thermal environment and air quality when designing climate-resilient public health responses. These findings enhance understanding of how climate-related environmental stressors influence COVID-19 transmission.
Ayudas:	European Commission 202258ACSL European Commission 101057554 Ministerio de Ciencia e Innovación RYC2023-042824-I
Nota:	Altres ajuts: Japan Society for the Promotion of Science (Grant Nos. 24 K23680 and 25 K20622); Czech Science Foundation (Grant No. 25-17587S); Swiss National Science Foundation (Grant No. TMSGI3_211626); Italian Ministry of University and Research under the Department of Excellence project 2023-2027 "ReDS - Rethinking Data Science".
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	COVID-19 ; Effect modification ; Humidex ; MCC collaborative research network ; PM2.5 ; Two-stage design
Publicado en:	Environment International, Vol. 208 (February 2026) , art. 110090, ISSN 1873-6750

DOI: 10.1016/j.envint.2026.110090

15 p, 4.1 MB

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