Recent ecological analyses suggest air pollution exposure may increase susceptibility to and severity of coronavirus disease 2019 (COVID-19). Individual-level studies are needed to clarify the relationship between air pollution exposure and COVID-19 outcomes. We conduct an individual-level analysis of long-term exposure to air pollution and weather on peak COVID-19 severity. We develop a Bayesian multinomial logistic regression model with a multiple imputation approach to impute partially missing health outcomes. Our approach is based on the stick-breaking representation of the multinomial distribution, which offers computational advantages, but presents challenges in interpreting regression coefficients. We propose a novel inferential approach to address these challenges. In a simulation study, we demonstrate our method's ability to impute missing outcome data and improve estimation of regression coefficients compared to a complete case analysis. In our analysis of 55,273 COVID-19 cases in Denver, Colorado, increased annual exposure to fine particulate matter in the year prior to the pandemic was associated with increased risk of severe COVID-19 outcomes. We also found COVID-19 disease severity to be associated with interactions between exposures. Our individual-level analysis fills a gap in the literature and helps to elucidate the association between long-term exposure to air pollution and COVID-19 outcomes.

中文翻译：

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空气污染与 COVID-19 疾病严重程度之间的关联通过贝叶斯多项逻辑回归与部分缺失的结果

最近的生态分析表明，空气污染暴露可能会增加对 2019 年冠状病毒病 (COVID-19) 的易感性和严重性。需要进行个体层面的研究来阐明空气污染暴露与 COVID-19 结果之间的关系。我们对长期暴露于空气污染和天气的 COVID-19 严重程度进行了个人层面的分析。我们开发了一个贝叶斯多项逻辑回归模型，该模型采用多重插补方法来插补部分缺失的健康结果。我们的方法基于多项分布的断棒表示，它提供了计算优势，但在解释回归系数时提出了挑战。我们提出了一种新颖的推理方法来应对这些挑战。在模拟研究中，我们展示了我们的方法' s 与完整案例分析相比，估算缺失结果数据和改进回归系数估计的能力。在我们对科罗拉多州丹佛市的 55,273 例 COVID-19 病例的分析中，在大流行前一年，每年接触细颗粒物的增加与严重 COVID-19 结果的风险增加有关。我们还发现 COVID-19 疾病的严重程度与暴露之间的相互作用有关。我们的个人层面分析填补了文献中的空白，有助于阐明长期暴露于空气污染与 COVID-19 结果之间的关联。在大流行前一年，每年对细颗粒物的接触增加与 COVID-19 严重后果的风险增加有关。我们还发现 COVID-19 疾病的严重程度与暴露之间的相互作用有关。我们的个人层面分析填补了文献中的空白，有助于阐明长期暴露于空气污染与 COVID-19 结果之间的关联。在大流行前一年，每年对细颗粒物的接触增加与 COVID-19 严重后果的风险增加有关。我们还发现 COVID-19 疾病的严重程度与暴露之间的相互作用有关。我们的个人层面分析填补了文献中的空白，有助于阐明长期暴露于空气污染与 COVID-19 结果之间的关联。