The impact of outdoor air pollution on COVID-19: a review of evidence from in vitro, animal, and human studies
- PMID: 33568525
- PMCID: PMC7879496
- DOI: 10.1183/16000617.0242-2020
The impact of outdoor air pollution on COVID-19: a review of evidence from in vitro, animal, and human studies
Abstract
Studies have pointed out that air pollution may be a contributing factor to the coronavirus disease 2019 (COVID-19) pandemic. However, the specific links between air pollution and severe acute respiratory syndrome-coronavirus-2 infection remain unclear. Here we provide evidence from in vitro, animal and human studies from the existing literature. Epidemiological investigations have related various air pollutants to COVID-19 morbidity and mortality at the population level, however, those studies suffer from several limitations. Air pollution may be linked to an increase in COVID-19 severity and lethality through its impact on chronic diseases, such as cardiopulmonary diseases and diabetes. Experimental studies have shown that exposure to air pollution leads to a decreased immune response, thus facilitating viral penetration and replication. Viruses may persist in air through complex interactions with particles and gases depending on: 1) chemical composition; 2) electric charges of particles; and 3) meteorological conditions such as relative humidity, ultraviolet (UV) radiation and temperature. In addition, by reducing UV radiation, air pollutants may promote viral persistence in air and reduce vitamin D synthesis. Further epidemiological studies are needed to better estimate the impact of air pollution on COVID-19. In vitro and in vivo studies are also strongly needed, in particular to more precisely explore the particle-virus interaction in air.
Copyright ©ERS 2021.
Conflict of interest statement
Conflict of interest: T. Bourdrel has nothing to disclose. Conflict of interest: I. Annesi-Maesano has nothing to disclose. Conflict of interest: B. Alahmad has nothing to disclose. Conflict of interest: C.N. Maesano has nothing to disclose. Conflict of interest: M-A. Bind has nothing to disclose.
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