Acute and chronic exposure to air pollution in relation with incidence, prevalence, severity and mortality of COVID-19: a rapid systematic review (original) (raw)
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Integrated Environmental Assessment and Management, 2021
Several epidemiological studies have suggested a link between air pollution and respiratory tract infections. The outbreak of coronavirus disease 2019 (COVID-19) poses a great threat to public health worldwide. However, some parts of the globe have been worse affected in terms of prevalence and deaths than others. The causes and conditions of such variations have yet to be explored. Although some studies indicated a possible correlation between air pollution and COVID-19 severity, there is yet insufficient data for a meaningful answer. This review summarizes the impact of air pollution on COVID-19 infections and severity and discusses the possible management strategies and challenges involved. The available literature investigating the correlation between air pollution and COVID-19 infections and mortality are included in the review. The studies reviewed here suggest that exposure to air pollution, particularly to PM 2.5 and NO 2 , is positively correlated with COVID-19 infections and mortality. Some data indicate that air pollution can play an important role in the airborne transmission of SARS-CoV-2. A high percentage of COVID-19 incidences has been reported in the most polluted areas, where patients needed hospital admission. The available data also show that both short-term and long-term air pollution may enhance COVID-19 severity. However, most of the studies that showed a link between air pollution and COVID-19 infections and mortality did not consider potential confounders during the correlation analysis. Therefore, more specific studies need to be performed focusing on some additional confounders such as individual age, population density, and pre-existing comorbidities to determine the impact of air pollution on COVID-19 infections and deaths. Integr Environ Assess Manag 2021;00:1-9.
The impact of air pollution on the incidence and mortality of COVID-19
Global Health Research and Policy
Air pollution is the most significant environmental risk factor for all-cause mortality, and it has caused substantial disability-adjusted life-years and economic loss. Air pollution intensified the mortality during past pandemics, Spanish flu in 1918 and SARS-CoV-1 in 2003. It increases host susceptibility and virulence of respiratory infections and reduces viral clearance. Thus, a question arises whether there will be any impact of air pollution on the current pandemic coronavirus disease 2019 (COVID-19)? Thus far, history and science are directing towards an immense potential impact of air pollution on the COVID-19 pandemic. Some of the devastated countries with the current pandemic are those with a poor air quality index. Further epidemiological and ecological studies are necessary to confirm this association. Also, countries must mobilize funding for mitigation of air pollution to benefit environmental health and ameliorate its potential effects on pandemics of the future.
Journal of Medical Virology, 2021
Evidence in the literature suggests that air pollution exposure affects outcomes of patients with COVID-19. However, the extent of this effect requires further investigation. This study was designed to investigate the relationship between longterm exposure to air pollution and the case fatality rate (CFR) of patients with COVID-19. The data on air quality index (AQI), PM2.5, PM10, SO 2 , NO 2 , and O 3 from 14 major cities in China in the past 5 years (2015-2020) were collected, and the CRF of COVID-19 patients in these cities was calculated. First, we investigated the correlation between CFR and long-term air quality indicators. Second, we examined the air pollutants affecting CFR and evaluated their predictive values. We
Aerosol and Air Quality Research, 2021
Since the outbreak of COVID-19 pandemic, several researchers worldwide have suggested chronic exposure to air pollutants viz. PM2.5, NO2, and O3 as one of the influencing factors for the increased rate of fatality. However, most of these studies lacked a comprehensive international outlook. A strong correlation on a regional scale might require further investigations to evaluate the transboundary validity. Therefore, the current study aims to explore the statistical soundness of association of COVID-19 fatality with PM2.5, NO2, and O3 concentration levels across 463 air quality monitoring stations located in 35 selected cities from USA, India and European Regions (France, Germany and Italy). An aggregated open-source air quality data source was used to download the PM2.5, NO2, and O3 concentration for > 900 days in the selected cities. The median of this long-term exposure was tested against the COVID-19 fatality rates. A strength of association parameter, ω 2 , and the coefficient of determination, R 2 , were used to evaluate the transboundary association. ω 2 results indicated that only 24.6%, 0.03% and 15.4% of the variation in COVID-19 fatality rates could be explained using PM2.5, NO2, and O3 concentrations respectively for all the analyzed cities. Further, low values of R 2 between pollutant concentrations and COVID-19 fatality rates corroborated the results (0.27 for PM2.5, 0.00038 for NO2 and 0.18 for O3). These observations strongly suggest a focal shift towards the inclusion of more explanatory variables and an extensive multidisciplinary work is required in order to understand the cause of COVID-19 fatality.
Air quality and COVID-19 adverse outcomes: Divergent views and experimental findings
Environmental Research, 2021
Background: The questioned link between air pollution and coronavirus disease 2019 (COVID-19) spreading or related mortality represents a hot topic that has immediately been regarded in the light of divergent views. A first "school of thought" advocates that what matters are only standard epidemiological variables (i.e. frequency of interactions in proportion of the viral charge). A second school of thought argues that co-factors such as quality of air play an important role too. Methods: We analyzed available literature concerning the link between air quality, as measured by different pollutants and a number of COVID-19 outcomes, such as number of positive cases, deaths, and excess mortality rates. We reviewed several studies conducted worldwide and discussing many different methodological approaches aimed at investigating causality associations. Results: Our paper reviewed the most recent empirical researches documenting the existence of a huge evidence produced worldwide concerning the role played by air pollution on health in general and on COVID-19 outcomes in particular. These results support both research hypotheses, i.e. long-term exposure effects and short-term consequences (including the hypothesis of particulate matter acting as viral "carrier") according to the two schools of thought, respectively. Conclusions: The link between air pollution and COVID-19 outcomes is strong and robust as resulting from many different research methodologies. Policy implications should be drawn from a "rational" assessment of these findings as "not taking any action" represents an action itself. 1. Introduction: pieces of the puzzle, research questions and schools of thoughts
Effects of Air Pollution on COVID-19 and Public Health
2020
The pandemic of coronavirus disease 2019 (COVID-19), generate by a novel virus SARS-CoV-2, is rapidly spreading all over the world, generating a high number of deaths. One of the current questions in the field of environmental science is to explain the relationships determining the diffusion of COVID-19 in specific regions of countries. The research here focuses on case study of Italy, one of the countries in the World to experience a rapid increase in confirmed cases and deaths. Results suggest that diffusion of COVID-19 is very high in cities with high air pollution generating severe negative effects on public health o. In particular, results reveal that, among Italian provincial capitals, the number of infected people was higher in cities with more than 100 days per year exceeding limits set for PM10 or ozone, cities located in hinterland zones (i.e. away from the coast), cities having a low average intensity of wind speed and cities with a lower temperature. In hinterland cities...
Long-Term Air Pollution Exposure and COVID-19 Mortality: A Patient-Level Analysis from New York City
American Journal of Respiratory and Critical Care Medicine, 2021
Rationale: Risk factors for coronavirus disease (COVID-19) mortality may include environmental exposures such as air pollution. Objectives: To determine whether, among adults hospitalized with PCR-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), long-term air pollution exposure is associated with the risk of mortality, ICU admission, or intubation. Methods: We performed a retrospective analysis of SARS-CoV-2 PCR-positive patients admitted to seven New York City hospitals from March 8, 2020, to August 30, 2020. The primary outcome was mortality; secondary outcomes were ICU admission and intubation. We estimated the annual average fine particulate matter (particulate matter <2.5 μm in aerodynamic diameter [PM 2.5 ]), nitrogen dioxide (NO 2), and black carbon (BC) concentrations at patients' residential address. We employed double robust Poisson regression to analyze associations between the annual average PM 2.5 , NO 2 , and BC exposure level and COVID-19 outcomes, adjusting for age, sex, race or ethnicity, hospital, insurance, and the time from the onset of the pandemic. Results: Among the 6,542 patients, 41% were female and the median age was 65 (interquartile range, 53-77) years. Over 50% self-identified as a person of color (n = 1,687 [26%] Hispanic patients; n = 1,659 [25%] Black patients). Air pollution exposure levels were generally low. Overall, 31% (n = 2,044) of the cohort died, 19% (n = 1,237) were admitted to the ICU, and 16% (n = 1,051) were intubated. In multivariable models, a higher level of long-term exposure to PM 2.5 was associated with an increased risk of mortality (risk ratio, 1.11 [95% confidence interval, 1.02-1.21] per 1-μg/m 3 increase in PM 2.5) and ICU admission (risk ratio, 1.13 [95% confidence interval, 1.00-1.28] per 1-μg/m 3 increase in PM 2.5). In multivariable models, neither NO 2 nor BC exposure was associated with COVID-19 mortality, ICU admission, or intubation. Conclusions: Among patients hospitalized with COVID-19, a higher long-term PM 2.5 exposure level was associated with an increased risk of mortality and ICU admission.
Effect of Air Pollution on the Occurrences and Death of COVID-19
International Healthcare Research Journal, 2021
Air contamination continues to be the leading environmental risk factor for all causes of death, leading to substantial years of lives and economic decline adapted to incapacity increased deaths in air pollution in past pandemics, in 1918, Spanish Flu and in 2003 with SARS-CoV-1. The host susceptibility and respiratory virulence are increased and viral clearance is decreased. Therefore, there is a question about the effect of air contamination on the current 2019 coronavirus pandemic (COVID-19). History and research have until now been concerned with the huge potential consequences of the COVID-19 air pollution pandemic. In order to validate this correlation, more epidemiological and environmental research is necessary. Moreover, countries must leverage air emissions reduction funds to benefit their wellbeing and enhance their possible impact on future pandemics.
Air Pollution and COVID-19 Pandemic: A Review
International Journal of Advanced Research, 2020
have been aimed at understanding the character of the virus, the etiology and epidemiology of the disease, its mode of transmission and control. The virus has been understood to be transmitted through the air environment and via surfaces (Quin et al., 2020; Kampf et al., 2020), and air pollution has naturally been a major subject of study in this regard. Other researchers (Ogen, 2020) have indicated that since air pollution also leads to chronic respiratory stress, it could also limit the ability of the human body to defend itself from infections, including that of COVID-19. Even though the lockdown imposed in many cities have, incidentally, resulted in temporary improvement in the quality of the local air environment, this impact could be just a temporary gain (Quin et al. 2020). This paper reviews the impact of air pollution on this pandemic and how it's management can help in controlling it. Air Pollution Sources and Characteristics of Major Air Pollutants Air pollution refers to the release of a materials into the air that are detrimental to human health and the ecosystem. The substance can be solid particles, liquid droplets, or gases. A pollutant can be of natural origin or man-made. According to Kamal (2017), the major air pollution sources include: mobile sources (such as cars, buses, planes, trucks, and trains), stationary sources (such as power plants, oil refineries, industrial facilities, and factories), area sources (such as