The impact of outdoor air pollution on COVID-19: a review of evidence from in vitro , animal, and human studies
Open accessAbstract
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.
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- Authors
- Bourdrel, T., Annesi-Maesano, I., Alahmad, B., Maesano, C. N., & Bind, M.-A.
- Affiliations
- Hôpitaux Universitaires de Strasbourg (FR)
- Harvard University (US)
- Inserm (FR)
- Corresponding author
- Bourdrel, Thomas
- Venue
- European Respiratory Review
- Publisher
- European Respiratory Society (ERS)
- Published
- 2021-02-09
- Volume
- 30
- Issue
- 159
- Pages
- 200242
- ISSN
- 0905-9180 (ISSN-L)
- 1600-0617
- PMC
- PMC7879496
- OpenAlex
- W3128253629
- Cited by
- 224
- References
- 119
- Citations by year
- 2026: 9 · 2025: 25 · 2024: 29 · 2023: 41 · 2022: 70 · 2021: 50
- FWCI
- 4.12
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- European Respiratory Review (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institutes of Health (DP5OD021412)
- Topics
- Physical Sciences › Environmental Science › Global and Planetary Change › COVID-19 impact on air quality
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
- Keywords
- outdoor air pollution, COVID-19 pandemic, SARS-CoV-2, air pollutants, immune response, vitamin D synthesis, ultraviolet radiation, relative humidity, weather conditions, cardiopulmonary disease, diabetes mellitus, COVID-19 mortality, COVID-19 severity
- MeSH terms
- COVID-19, SARS-CoV-2, Air Pollutants, Air Pollution, Animals, Environmental Exposure, Humans, Prognosis, Risk Factors, Severity of Illness Index, Risk Assessment, Host-Pathogen Interactions
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