The DOI matches its Crossref record; 64 of the 65 references it cites were found in a registry or an index.
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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Cites
A pneumonia outbreak associated with a new coronavirus of probable bat origin
Zhou, P., Yang, X.-L., Wang, X.-G., Hu, B., Zhang, L., Zhang, W., Si, H.-R., Zhu, Y., Li, B., Huang, C.-L., et al. (2020) · Nature · doi:10.1038/s41586-020-2012-7 · Cited by 21,969
Richardson, S., Hirsch, J. S., Narasimhan, M., Crawford, J. M., McGinn, T., Davidson, K. W., and the Northwell COVID-19 Research Consortium, Barnaby, D. P., Becker, L. B., Chelico, J. D., et al. (2020) · JAMA · doi:10.1001/jama.2020.6775 · Cited by 9,254
A novel coronavirus outbreak of global health concern
Wang, C., Horby, P. W., Hayden, F. G., & Gao, G. F. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30185-9 · Cited by 7,700
Factors associated with COVID-19-related death using OpenSAFELY
Williamson, E. J., Walker, A. J., Bhaskaran, K., Bacon, S., Bates, C., Morton, C. E., Curtis, H. J., Mehrkar, A., Evans, D., Inglesby, P., et al. (2020) · Nature · doi:10.1038/s41586-020-2521-4 · Cited by 6,674
Cohen, A. J., Brauer, M., Burnett, R., Anderson, H. R., Frostad, J., Estep, K., Balakrishnan, K., Brunekreef, B., Dandona, L., Dandona, R., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)30505-6 · Cited by 6,583
Brook, R. D., Rajagopalan, S., Pope, C. A., Brook, J. R., Bhatnagar, A., Diez-Roux, A. V., Holguin, F., Hong, Y., Luepker, R. V., Mittleman, M. A., et al. (2010) · Circulation · doi:10.1161/cir.0b013e3181dbece1 · Cited by 6,548
Endothelial cell infection and endotheliitis in COVID-19
Varga, Z., Flammer, A. J., Steiger, P., Haberecker, M., Andermatt, R., Zinkernagel, A. S., Mehra, M. R., Schuepbach, R. A., Ruschitzka, F., & Moch, H. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30937-5 · Cited by 6,358
Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19
Ackermann, M., Verleden, S. E., Kuehnel, M., Haverich, A., Welte, T., Laenger, F., Vanstapel, A., Werlein, C., Stark, H., Tzankov, A., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2015432 · Cited by 5,613
The Lancet Commission on pollution and health
Landrigan, P. J., Fuller, R., Acosta, N. J. R., Adeyi, O., Arnold, R., Basu, N. (., Baldé, A. B., Bertollini, R., Bose-O'Reilly, S., Boufford, J. I., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(17)32345-0 · Cited by 4,929
Self-citationAssociation of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China
Shi, S., Qin, M., Shen, B., Cai, Y., Liu, T., Yang, F., Gong, W., Liu, X., Liang, J., Zhao, Q., et al. (2020) · JAMA Cardiology · doi:10.1001/jamacardio.2020.0950 · Cited by 4,349
Research works printed but not linked: 1
- Ostro, 2004, World Health Organization Protection of the Human Environment
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Sachs, J. D., Karim, S. S. A., Aknin, L., Allen, J., Brosbøl, K., Colombo, F., Barron, G. C., Espinosa, M. F., Gaspar, V., Gaviria, A., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(22)01585-9 · Cited by 842
Self-citationOECD (2021) · OECD eBooks · doi:10.1787/2965f4fe-en · Cited by 500
Rajagopalan, S., & Landrigan, P. J. (2021) · New England Journal of Medicine · doi:10.1056/nejmra2030281 · Cited by 350
Air pollution deaths attributable to fossil fuels: observational and modelling study
Lelieveld, J., Haines, A., Burnett, R., Tonne, C., Klingmüller, K., Münzel, T., & Pozzer, A. (2023) · BMJ · doi:10.1136/bmj-2023-077784 · Cited by 289
Self-citationThe role of seasonality in the spread of COVID-19 pandemic
Liu, X., Huang, J., Li, C., Zhao, Y., Wang, D., Huang, Z., & Yang, K. (2021) · Environmental Research · doi:10.1016/j.envres.2021.110874 · Cited by 269
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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