Effects of short- and long-term exposure to atmospheric pollution on COVID-19 risk and fatality: analysis of the first epidemic wave in northern Italy

Abstract

The effects of exposure to atmospheric pollution on the incidence and mortality due to COVID-19 have been studied but not for sulfur dioxide (SO 2 ) in most studies. However, most studies failed to consider important cofounding factors in the estimation of health effects of air pollution. The objective of the study was to assess the short- and long-term effects of air pollution on the COVID-19 risk and fatality in Lombardy and Veneto. Air pollutants were studied based on monitoring station information in Lombardy and Veneto from January 2013 to May 2020. The daily number of cases and deaths of COVID-19 were collected from the reports of the Italian Ministry of Health in Italy. A generalized linear model with the generalized estimating equation method was used to evaluate the effects of short- and long-term exposure to air pollution on the COVID-19 outbreak in Lombardy and Veneto. After adjusting for other covariates, we found that short-term exposure to PM 2.5 and PM 10 had a tendency to increase the incidence and mortality of COVID-19 than long-term exposure, while for other air pollutants, including SO 2 and NO 2 , long-term exposure was more significant than short-term exposure. Both short- and long-term exposure of SO 2 resulted in increased health effects on COVID-19 pandemic. Our findings suggest that exposure to atmospheric pollution has a significant impact on COVID-19 pandemic and call for further researches to deeply investigate this topic.

Positive association between outdoor air pollution and the incidence and severity of COVID-19. A review of the recent scientific evidences

“…It would be probably linked to an increased susceptibility of the host, which in turn, could be due to the dysregulation of the immune system, or also to the worsening of the conditions associated with severe SARS-CoV-2 infections. Recently, Ho et al (2021) have reported the results of an analysis performed in the Lombardy and Veneto regions, on the contribution of NO 2 , PM 2.5 , PM 10 , O 3 and SO 2 to the incidence, mortality, and fatality rates of COVID-19, both short- and long-term exposure for 8 years (January 2013–May 2020). The most striking result was the finding of the significant role of exposure to SO 2 in COVID-19 pandemic via inducing systemic and respiratory inflammation.…”

Effects of environmental parameters and their interactions on the spreading of SARS-CoV-2 in North Italy under different social restrictions. A new approach based on multivariate analysis

“…had already been observed in comparison with other countries during this time period (the so-called second wave; Bontempi, 2021). A modification of the relationships between atmospheric parameters and the COVID-19 diffusion had been already observed earlier in Italy and it was due to the lockdown during the spring season ( Benedetti et al, 2020 ; Ho et al, 2021 ). Also, on a global scale the public health interventions are considered to induce a major impact on the prevention of COVID-19 diffusion in comparison with seasonal factors ( Jüni et al, 2020 ; Paraskevis et al, 2021 ).…”

“…the first month ( Pivato et al, 2021 ; Pirouz et al, 2020 ; Collivignarelli et al, 2021 ; Haghshenas et al, 2020 ; Bontempi, 2020 ; Passerini et al, 2020 ; Ye et al, 2021 ; Sfîcă et al, 2020 ; Khursheed et al, 2021 ; Coker et al, 2020 ; Bianconi et al, 2020 ; Accarino et al, 2021 ; Perone, 2021 ; Filippini et al, 2021 ; Kotsiou et al, 2021 ), or up to April 2020 ( Coccia, 2020 ; Delnevo et al, 2020 ; Fazzini et al, 2020 ; Filippini et al, 2020 ; Fattorini and Regoli, 2020 ; Zoran et al, 2020 ; De Angelis et al, 2021 ; Benedetti et al, 2020 ; Agnoletti et al, 2020 ). Only a few works have considered a wider time span, up to the end of spring ( Ho et al, 2021 ; Pansini and Fornacca, 2021 ; Lolli et al, 2020 ; Cascetta et al, 2021 ). The paper by Fiasca et al (2020) has studied the effect of air pollution until the end of November.…”

“…The evaluation of several polluting factors (O 3 , NO 2 , SO 2 in addition to PM10 and PM2.5) by Ho et al (2021) has led to finding that only the chronic pollution by particulate matter is significant for COVID-19 effects in Lombardia and Veneto, whereas on a daily basis the PM10 and PM2.5, are not, up to May 2020. A different conclusion was proposed by Ye et al (2021) in the same time period (up to May 2020).…”

“…Despite the daily variations of PM does not seem to represent an essential factor in highly populated plain areas from our data, a different role emerges when the effect of long-term pollution of particulate matter (years-months) is taken into account, according to the evidence available in the literature. Several studies have considered this effect in Italy and have reported higher pandemic diffusion in more historically polluted areas ( Bianconi et al, 2020 ; Coker et al, 2020 ; Fattorini and Regoli, 2020 ; Cascetta et al, 2021 ; De Angelis et al, 2021 ; Fiasca et al, 2021; Ho et al, 2021 ; Kotsiou et al, 2021 ; Pansini and Fornacca, 2021 ; Perone, 2021 ; Ye et al, 2021 ). The wide plain area of the Northern Italy ( Fig.…”