{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:14:22Z","timestamp":1783484062255,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>Ambient air pollution is known to exacerbate respiratory illnesses. However, its impact on COVID\u201019 outcomes remains underexplored. We investigated the association between ambient air pollution and outcomes in patients with moderate to severe COVID\u201019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analysed 1867 hospitalized patients from a multicentre Korean cohort. Individual\u2010level exposure to five air pollutants (SO\n                      <jats:sub>2<\/jats:sub>\n                      , CO, NO\n                      <jats:sub>2<\/jats:sub>\n                      , PM\n                      <jats:sub>10<\/jats:sub>\n                      and PM\n                      <jats:sub>2.5<\/jats:sub>\n                      ) was assessed over short\u2010term (3\u2010day) and long\u2010term (3\u2010year) periods. The risks of acute respiratory distress syndrome (ARDS) and 30\u2010day mortality were evaluated using models adjusted for clinical and meteorological factors. Pollutant exposure was analysed both as quartiles and continuous variables to estimate effects per unit increase.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Short\u2010term CO exposure was associated with increased ARDS incidence (per 0.1\u2009ppm increase OR 1.18) and 30\u2010day mortality (HR 1.15). Long\u2010term NO\n                      <jats:sub>2<\/jats:sub>\n                      exposure was associated with higher ARDS risk (per 1\u2009ppb OR 1.11). Long\u2010term PM\n                      <jats:sub>10<\/jats:sub>\n                      exposure was also associated with ARDS incidence (per 10\u2009\u03bcg\/m\n                      <jats:sup>3<\/jats:sup>\n                      OR 2.24). For mortality, short\u2010term NO\n                      <jats:sub>2<\/jats:sub>\n                      (per 1\u2009ppb HR 1.02) and PM\n                      <jats:sub>2.5<\/jats:sub>\n                      (per 10\u2009\u03bcg\/m\n                      <jats:sup>3<\/jats:sup>\n                      HR 1.14) exposure were additionally associated with increased risk. These associations were consistent in quartile\u2010based analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Both short\u2010 and long\u2010term exposure to ambient air pollution were associated with worse COVID\u201019 outcomes, including ARDS and mortality. CO, often overlooked in pollution surveillance, showed the most consistent impact. These findings highlight the importance of air quality in pandemic preparedness and public health policy.\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/resp70250-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/resp.70250","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T12:49:37Z","timestamp":1776170977000},"page":"745-755","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ambient Air Pollution and Risk of\n                    <scp>ARDS<\/scp>\n                    and Mortality in Moderate to Severe\n                    <scp>COVID<\/scp>\n                    \u201019"],"prefix":"10.1002","volume":"31","author":[{"given":"Seohyun","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6655-3084","authenticated-orcid":false,"given":"Hyonsoo","family":"Joo","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Uijeongbu Gyeonggi Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2096-7679","authenticated-orcid":false,"given":"Hye Seon","family":"Kang","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Bucheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang Dong","family":"Yeo","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9025-225X","authenticated-orcid":false,"given":"Jong Min","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8897-6598","authenticated-orcid":false,"given":"Hyung Woo","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Incheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeon Hee","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Pulmonology, Department of Internal Medicine Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea  Daejeon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3456-8123","authenticated-orcid":false,"given":"Myoungin","family":"Shin","sequence":"additional","affiliation":[{"name":"Maritime Technology Research Institute, Agency for Defense Development  Changwon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jangwon","family":"Lee","sequence":"additional","affiliation":[{"name":"SSTLabs Co., Ltd.  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