The impact of air pollution on COVID-19 incidence, severity, and mortality: A systematic review of studies in Europe and North America.
Environ Res
; 215(Pt 1): 114155, 2022 Dec.
Article
in English
| MEDLINE | ID: covidwho-2004062
ABSTRACT
BACKGROUND:
Air pollution is speculated to increase the risks of COVID-19 spread, severity, and mortality.OBJECTIVES:
We systematically reviewed studies investigating the relationship between air pollution and COVID-19 cases, non-fatal severity, and mortality in North America and Europe.METHODS:
We searched PubMed, Web of Science, and Scopus for studies investigating the effects of harmful pollutants, including particulate matter with diameter ≤2.5 or 10 µm (PM2.5 or PM10), ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2) and carbon monoxide (CO), on COVID-19 cases, severity, and deaths in Europe and North America through to June 19, 2021. Articles were included if they quantitatively measured the relationship between exposure to air pollution and COVID-19 health outcomes.RESULTS:
From 2,482 articles screened, we included 116 studies reporting 355 separate pollutant-COVID-19 estimates. Approximately half of all evaluations on incidence were positive and significant associations (52.7%); for mortality the corresponding figure was similar (48.1%), while for non-fatal severity this figure was lower (41.2%). Longer-term exposure to pollutants appeared more likely to be positively associated with COVID-19 incidence (63.8%). PM2.5, PM10, O3, NO2, and CO were most strongly positively associated with COVID-19 incidence, while PM2.5 and NO2 with COVID-19 deaths. All studies were observational and most exhibited high risk of confounding and outcome measurement bias.DISCUSSION:
Air pollution may be associated with worse COVID-19 outcomes. Future research is needed to better test the air pollution-COVID-19 hypothesis, particularly using more robust study designs and COVID-19 measures that are less prone to measurement error and by considering co-pollutant interactions.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Ozone
/
Air Pollutants
/
Air Pollution
/
COVID-19
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Reviews
/
Systematic review/Meta Analysis
Limits:
Humans
Language:
English
Journal:
Environ Res
Year:
2022
Document Type:
Article
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