key: cord-0936647-bft2mplr authors: Copat, Chiara; Cristaldi, Antonio; Fiore, Maria; Grasso, Alfina; Zuccarello, Pietro; Signorelli, Salvatore Santo; Conti, Gea Oliveri; Ferrante, Margherita title: The role of air pollution (PM and NO(2)) in COVID-19 spread and lethality: a systematic review date: 2020-08-24 journal: Environ Res DOI: 10.1016/j.envres.2020.110129 sha: 28654a97050428ce4a401e163ade852a42fa24d0 doc_id: 936647 cord_uid: bft2mplr A new coronavirus (SARS-CoV-2) has determined a pneumonia outbreak in China (Wuhan, Hubei Province) in December 2019, called COVID-19 disease. In addition to the person-to person transmission dynamic of the novel respiratory virus, it has been recently studied the role of environmental factors in accelerate SARS-CoV-2 spread and its lethality. The time being, air pollution has been identified as the largest environmental cause of disease and premature death in the world. It affects body's immunity, making people more vulnerable to pathogens. The hypothesis that air pollution, resulting from a combination of factors such as meteorological data, level of industrialization as well as regional topography, can acts both as a carrier of the infection and as a worsening factor of the health impact of COVID-19 disease, has been raised recently. With this review, we want to provide an update state of art relating the role of air pollution, in particular PM(2.5), PM(10) and NO(2), in COVID-19 spread and lethality. The Authors, who first investigated this association, often used different research methods or not all include confounding factors whenever possible. In addition, to date incidence data are underestimated in all countries and to a lesser extent also mortality data. For this reason, the cases included in the reviewed studies cannot be considered conclusive. Although it determines important limitations for direct comparison of results, and more studies are needed to strengthen scientific evidences and support firm conclusions, major findings are consistent, highlighting the important contribution of PM(2.5) and NO(2) as triggering of the COVID-19 spread and lethality, and with a less extent also PM(10), although the potential effect of airborne virus exposure it has not been still demonstrated. 32 33 and in vivo studies highlighted its role in the exacerbation of respiratory viral infections 161 (Becker and Soukup, 1999) . Recently, the research group of Setti et al., (2020) Table 1 ). 173 considering population size and density as potential confounders. They observed that the 182 effect of PM 2.5 on daily confirmed cases was greater than PM 10 . In particular they found 183 that a 10-μg/m 3 increase (lag0-14) in PM 2.5 and PM 10 was associated with a 2.24% (95% 184 CI: 1.02 to 3.46) and 1.76% (95% CI: 0.89 to 2.63) increase in the daily counts of COVID-185 19 confirmed cases, respectively. 186 Jiang et al., (2020) indicators of spatial association (LISA) map values, city size and population or proportion 206 of people older than 65 years. It was found that for every 10 μg/m 3 increase in PM 2.5 and 207 PM 10 , the CFR increased by 0.24% (0.01%-0.48%) and 0.26% (0.00%-0.51%) 208 respectively, and the risk estimates increased to 0.61% (0.09% -1.12%) and 0.33% (0. In U.S.A., the association was also studied by Bashir et al., (2020) for the state of 377 California. As discussed above for PM, the Authors found a negative correlation also 378 between NO 2 levels and COVID-19 cases and mortality. Nevertheless, they stated that this 379 pollutant contributes to the spread of the disease. 380 Based on these scientific evidences, in addition to confirming that exposure to NO 2 is 381 harmful to human health and increases the risk of incurring respiratory diseases, it can be 382 stated that exposure to NO 2 may be one of the most important trigger for the spread and 383 fatality caused by the COVID-19 disease. 384 The scientific evidences collected in the literature highlight the important contribution of 386 chronic exposure to air pollution on the COVID-19 spread and lethality, although the 387 potential effect of airborne virus exposure it has not been still demonstrated. In particular, it 388 seems that PM 2.5 and NO 2 are more closely correlated to COVID-19 than PM 10 . The lower 389 correlation of PM 10 with COVID-19 incidence and mortality can be due to the impossibility 390 of particulate matter greater than 5 µm to reach type II alveolar cells, where is located the Short-Term Effects of Ambient Ozone, PM2.5, and 422 Meteorological Factors on COVID-19 Confirmed Cases and Deaths in Queens, 423 New York Renin-angiotensin system at the 426 heart of COVID-19 pandemic Health impact 429 assessment of fine particle pollution at the regional level Health impacts quantification of ambient air pollutants using 433 AirQ model approach in Hamadan Correlation between environmental pollution indicators and COVID-19 437 pandemic: A brief study in Californian context Exposure to urban air particulates alters the macrophage-440 mediated inflammatory response to respiratory viral infection Commercial exchanges instead of air pollution as possible origin of 443 COVID-19 initial diffusion phase in Italy: More efforts are necessary to address 444 interdisciplinary research First data analysis about possible COVID-19 virus airborne diffusion 447 due to air particulate matter (PM): The case of Lombardy (Italy) Understanding COVID-19 diffusion 450 requires an interdisciplinary, multi-dimensional approach Short-term associations between outdoor air pollution and 454 mortality in London 1992-4 Influence of meteorological factors and air pollution on the outbreak 458 of severe acute respiratory syndrome PM10 exposure is 462 associated with increased hospitalizations for respiratory syncytial virus 463 bronchiolitis among infants in Lombardy Correlation between the 467 migration scale index and the number of new confirmed coronavirus disease 2019 468 cases in China Associations between 471 short-term exposure to gaseous pollutants and pulmonary heart disease-related 472 mortality among elderly people in Chengdu COVID-19 and climate: global evidence from 117 countries How High Wind Speed Can Reduce Negative Effects of Confirmed 478 Cases and Total Deaths of COVID-19 Infection in Society (SSRN Scholarly Paper 479 No. ID 3603380) Factors determining the diffusion of COVID-19 and suggested strategy 482 to prevent future accelerated viral infectivity similar to COVID The dramatic impact of Coronavirus outbreak on air quality: Has it 568 saved as much as it has killed so far? Glob Regulatory T cells and IL10 suppress pulmonary host defense during early-life 572 exposure to radical containing combustion derived ultrafine particulate matter Effect of ambient air pollutants and meteorological 575 variables on COVID-19 incidence Relationship between 578 ambient air pollution and daily mortality of SARS in Beijing Importance 584 of collecting data on socioeconomic determinants from the early stage of the 585 COVID-19 outbreak onwards A review of airborne polycyclic aromatic hydrocarbons (PAHs) and their 588 human health effects Effect of NOx and NO2 590 Concentration Increase in Ambient Air to Daily Bronchitis and Asthma 591 Air pollution and 594 temperature are associated with increased COVID-19 incidence: A time series 595 study The role of oxidative stress in ambient particulate matter-598 induced lung diseases and its implications in the toxicity of engineered 599 nanoparticles. Free Radic Beijing -temporal pattern and its association with influenza Coarse particulate matter and hospitalization for 605 respiratory infections in children younger than 15 years in Toronto: a case-crossover 606 analysis Ambient Particulate Air Pollution and Daily Mortality in 652 High incidence of venous thromboembolic events in 619 anticoagulated severe COVID-19 patients Performance, combustion, 622 and emission characteristics of a CI engine fueled with emulsified diesel-biodiesel 623 blends at different water contents Air Pollution and the Novel Covid-19 Disease: a 626 Putative Disease Risk Factor. Sn Compr Biochemical 629 and histological alterations in rats after acute nitrogen dioxide intoxication How can 637 airborne transmission of COVID-19 indoors be minimised? Assessing nitrogen dioxide (NO2) levels as a contributing factor to 640 coronavirus (COVID-19) fatality Oxidant injury increases cell surface 643 receptor binding of angiotensin II to pulmonary artery endothelial cells The Relationship between Airway Inflammation and 646 Exacerbation in Chronic Obstructive Pulmonary Disease Increased Chronic 649 Obstructive Pulmonary Disease Exacerbations of Likely Viral Etiology Follow 650 Elevated Ambient Nitrogen Oxides Acute Effects of Air Pollution on Hospital Admissions 654 for Asthma, COPD, and Bronchiectasis in Ahvaz Impact of Long-Term Exposures to Ambient PM2.5 and Ozone on 658 ARDS Risk for Older Adults in the United States Airborne SARS-CoV-2 Is Rapidly Inactivated by Simulated Sunlight Searching for SARS-COV-2 on Particulate Matter: 667 A Possible Early Indicator of COVID-19 Epidemic Recurrence Effect of particulate matter-bound metals exposure on prothrombotic 671 biomarkers: A systematic review Respiratory 674 viral infections and effects of meteorological parameters and air pollution in adults 675 with respiratory symptoms admitted to the emergency room Effects of Air Pollution and Other 679 Environmental Exposures on Estimates of Severe Influenza Illness Outdoor Air Pollution: Sources, Atmospheric Transport, and Human 682 Health Effects Early life exposure to air pollution and incidence of childhood asthma, 688 allergic rhinitis and eczema Aerosol and Surface Stability of 693 SARS-CoV-2 as Compared with SARS-CoV-1 Association Between Air Pollution in 697 Lima and the High Incidence of COVID-19: Findings from a Post Hoc Analysis Effects of urban coarse particles inhalation on oxidative and inflammatory 702 parameters in the mouse lung and colon Health effects of particulate matter. Policy implications for countries in 708 eastern Europe Exposure to air 710 pollution and COVID-19 mortality in the United States Association of particulate matter pollution and case fatality rate of COVID-19 714 in 49 Chinese cities Mortality assessment attributed to long-term exposure to fine 718 particles in ambient air of the megacity of Tehran Association between short-term exposure to air 721 pollution and COVID-19 infection: Evidence from China Assessing the 724 relationship between surface levels of PM2.5 and PM10 particulate matter impact 725 on COVID-19 in Milan Assessing the 728 relationship between ground levels of ozone (O3) and nitrogen dioxide (NO2) with 729 coronavirus (COVID-19 Temporal association between daily confirmed cases and air pollution PM2.5, PM10 and NO2) Simple linear regression Wuhan 2020) Data up to March 22nd 49 cities of China Spatial association between fatality rate and air pollution The authors declare no conflict of interest. We have no funding to declare. 420 J o u r n a l P r e -p r o o f ☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.☐The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:J o u r n a l P r e -p r o o f