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