Cited by 463Air Quality and Health ImpactsCOVID-19 impact on air qualityInfection Control and Ventilation

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Regional and global contributions of air pollution to risk of death from COVID-19

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Pozzer, Andrea, Dominici, Francesca, Haines, Andy, Witt, Christian, Münzel, Thomas, Lelieveld, Jos·2020·Cardiovascular Research

DOI 10.1093/cvr/cvaa288PMC PMC7797754

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Abstract

Aims: The risk of mortality from the coronavirus disease that emerged in 2019 (COVID-19) is increased by comorbidity from cardiovascular and pulmonary diseases. Air pollution also causes excess mortality from these conditions. Analysis of the first severe acute respiratory syndrome coronavirus (SARS-CoV-1) outcomes in 2003, and preliminary investigations of those for SARS-CoV-2 since 2019, provide evidence that the incidence and severity are related to ambient air pollution. We estimated the fraction of COVID-19 mortality that is attributable to the long-term exposure to ambient fine particulate air pollution. Methods and results: We characterized global exposure to fine particulates based on satellite data, and calculated the anthropogenic fraction with an atmospheric chemistry model. The degree to which air pollution influences COVID-19 mortality was derived from epidemiological data in the USA and China. We estimate that particulate air pollution contributed ∼15% (95% confidence interval 7–33%) to COVID-19 mortality worldwide, 27% (13 – 46%) in East Asia, 19% (8–41%) in Europe, and 17% (6–39%) in North America. Globally, ∼50–60% of the attributable, anthropogenic fraction is related to fossil fuel use, up to 70–80% in Europe, West Asia, and North America. Conclusion: Our results suggest that air pollution is an important cofactor increasing the risk of mortality from COVID-19. This provides extra motivation for combining ambitious policies to reduce air pollution with measures to control the transmission of COVID-19.

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Authors: Pozzer, A., Dominici, F., Haines, A., Witt, C., Münzel, T., & Lelieveld, J.
Affiliations: The Abdus Salam International Centre for Theoretical Physics (ICTP) (IT)
Harvard University (US)
London School of Hygiene & Tropical Medicine (GB)
Charité – Universitätsmedizin Berlin (DE)
University Medical Center of the Johannes Gutenberg University Mainz (DE)
Cyprus Institute (CY)
Corresponding author: Münzel, Thomas
Lelieveld, Jos
ORCID: Pozzer, Andrea
Dominici, Francesca
Haines, Andy
Witt, Christian
Münzel, Thomas
Lelieveld, Jos
Venue: Cardiovascular Research
Publisher: Oxford University Press (OUP)
Published: 2020-10-26
Volume: 116
Issue: 14
Pages: 2247-2253
ISSN: 0008-6363 (ISSN-L)
1755-3245
DOI: 10.1093/cvr/cvaa288
PMC: PMC7797754
OpenAlex: W3105596189
Cited by: 463
References: 65
Citations by year: 2026: 13 · 2025: 11 · 2024: 26 · 2023: 67 · 2022: 102 · 2021: 129 · 2020: 114
FWCI: 41.22
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc
creativecommons.org/licenses/by-nc/4.0/ (vor, 1 d)
Locations: Cardiovascular Research (publishedVersion, cc-by-nc)
Europe PMC (PubMed Central) (publishedVersion, other-oa)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
MPG.PuRe (Max Planck Society) (submittedVersion)
Funders: DZHK
German Center for Cardiovascular Research
Partner Site Rhine-Main
Topics: Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
Physical Sciences › Environmental Science › Global and Planetary Change › COVID-19 impact on air quality
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
Keywords: COVID-19 mortality, air pollution, PM2.5, ambient air pollution exposure, attributable fraction, fossil fuel consumption, anthropogenic emissions, cardiovascular comorbidity, SARS-CoV-2, air quality policy
MeSH terms: COVID-19, Air Pollutants, Air Pollution, Asia, Environmental Exposure, Europe, Humans, Models, Theoretical, North America, Risk Factors, Time Factors, Global Health, Risk Assessment, Particulate Matter

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Regional and global contributions of air pollution to risk of death from COVID-19

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