Hubungan Partikulat (PM2,5) Terhadap Infeksi dan Kematian COVID-19 di Asia: Systematic Review dan Meta-Analysis

FRISCA RAHMADINA, dr. Riris Andono Ahmad, MPH., Ph.D; Aditya Lia Ramadona, S.Si., M.Sc., Ph.D

2022 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar Belakang: Tujuh dari sepuluh negara dengan pencemaran PM2,5 tertinggi di dunia adalah negara-negara berpendapatan rendah dan menengah di Asia. Kurangnya sumber daya untuk memantau kualitas udara menjadi salah satu penyebab tingginya polusi udara pada negara-negara tersebut. Telah banyak penelitian yang menghubungkan PM2,5 dengan penyakit pernapasan termasuk COVID-19. Sementara itu, awal Februari 2022, lebih dari 400 juta orang telah terinfeksi COVID-19 dan menyebabkan lebih dari 5 juta kematian COVID-19. Maka itu, perlu dipastikan keterkaitan antara PM2,5 dengan COVID-19. Tujuan: Menganalisis hubungan PM2,5 terhadap infeksi dan kematian COVID-19 menggunakan meta-analysis. Metode: Melakukan pencarian artikel yang berhubungan dengan PM2,5 dan COVID-19 di BioMed Central, Cochrane Library, Google Scholar, ProQuest, PubMed, SAGE Journal, dan Scopus. Hanya artikel berbahasa Inggris yang digunakan. Pencarian artikel dilakukan pada 01 Maret 2022. Meta-analysis dilakukan dengan random-effects model. Nomor registrasi PROSPERO: CRD42022316008. Hasil: Terdapat 14 artikel yang dilakukan meta-analysis. Hasil menunjukkan konsentrasi PM2,5 berhubungan secara signifikan terhadap peningkatan infeksi COVID-19 (relative risk = 1,20, 95% CI : 1,14 � 1,26). Paparan jangka pendek PM2,5 juga berhubungan terhadap infeksi COVID-19 (relative risk = 1,12, 95% CI : 1,07 � 1,18). Adanya hubungan paparan jangka panjang PM2,5 terhadap infeksi COVID-19 (relative risk = 1,41, 95% CI : 1,28 � 1,56). Hasil juga menunjukkan adanya hubungan antara konsentrasi PM2,5 terhadap kematian COVID-19 (relative risk = 1,37, 95% CI : 0,80 � 2,33). Adanya hubungan antara paparan jangka pendek PM2.5 terhadap kematian COVID-19 (relative risk = 1,37, 95% CI : 0,80 � 2,33). Sedangkan hubungan paparan jangka panjang PM2,5 terhadap kematian COVID-19 tidak dapat dipastikan karena tidak mendapat artikel mengenai hal tersebut. Selain itu, mobilitas penduduk dan kepadatan penduduk justru terlihat lebih mempengaruhi COVID-19. Kesimpulan: PM2,5 berhubungan dengan infeksi dan kematian COVID-19 di Asia tetapi juga dipengaruhi oleh faktor-faktor lainnya. Mitigasi polusi udara perlu dibuat untuk mengurangi polusi udara yang mungkin juga dapat mengurangi kontribusi terhadap COVID-19.

Background: Seven of the ten countries with the most polluted PM2.5 globally are low-and middle-income countries in Asia. The lack of resources to monitor air quality is one of the causes of the high pollution in these countries. Earlier studies have shown that air pollution is related to respiratory diseases, including COVID-19. By February 2022, COVID-19 had become prevalent globally, with more than 400 million confirmed cases and 5 million deaths. Therefore, this study investigates the linkage between PM2.5 and COVID-19. Objectives: This study aimed to explore the association between PM2.5 and COVID-19 infection and mortality using a meta-analysis. Methods: This study searched for articles related to PM2.5 and COVID-19 in BioMed Central, Cochrane Library, Google Scholar, ProQuest, PubMed, SAGE Journal, and Scopus. We only considered English articles. We conducted the article search on March 01, 2022. Pooled estimates and 95% confidence intervals were obtained with a random-effects model. PROSPERO registration number: CRD42022316008. Results: A total of 14 articles were eligible for meta-analysis. The result showed that PM2.5 concentration was significantly associated with increasing COVID-19 infection (relative risk = 1.20, 95% CI: 1.14 � 1.26). The short-term of PM2.5 was also associated with COVID-19 infection (relative risk = 1.12, 95% CI: 1.07 � 1.18). The long-term of PM2.5 was associated with COVID-19 infection (relative risk = 1.41, 95% CI: 1.28 � 1.56). PM2.5 concentration was associated with COVID-19 death (relative risk = 1.37, 95% CI: 0.80 � 2.33). The short-term of PM2.5 was also associated with COVID-19 mortality (relative risk = 1.37, 95% CI: 0.80 � 2.33). However, we did not find sufficient evidence to discuss the long-term association between PM2.5 and COVID-19 mortality. Besides, population mobility and population density seemed more affect COVID-19. Conclusions: Thus, PM2.5 was associated with COVID-19 infection and mortality in low-and-middle Asian countries, but it was also affected by other factors. Some air pollution mitigations may be affected to reduce COVID-19.

Kata Kunci : Partikulat, Polusi udara, Infeksi COVID-19, Kematian COVID-19