HighlightsBackground: Research on viral respiratory infections has found that infection risks increase following exposure to high concentrations of particulate matter. Several hot-spots of Severe Acute Respiratory Syndrome Coronavirus 2 infections are in areas associated with high levels of air pollution.Approach: This study investigates the relationship between exposure to particulate matter and COVID-19 incidence in 355 municipalities in the Netherlands using data on confirmed cases and hospital admissions coded by residence, along with local PM 2.5 , PM 10 , population density, demographics and health-related pre-conditions. The analysis utilizes different regression specifications that allow for spatial dependence, nonlinearity, alternative error distributions and outlier treatment.Results: PM 2.5 is a highly significant predictor of the number of confirmed COVID-19 cases and related hospital admissions. Taking the WHO guideline of 10mcg/m3 as a baseline, the estimates suggest that expected COVID-19 cases increase by nearly 100% when pollution concentrations increase by 20%. Conclusion:The findings call for further investigation into the association between air pollution on SARS-CoV-2 infection risk. If particulate matter plays a significant role in the incidence of COVID-19 disease, it has strong implications for the mitigation strategies required to prevent spreading, particularly in areas that have high levels of pollution.

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