“…Based on our results, we could thus infer that higher exposure to PM2.5, PM10 and NO2 can contribute to a worst Covid-19 course also among MS patients. Since a link between air pollutants, including PM2.5, PM10, NO2, and MS was already found ( Bergamaschi et al, 2021 , Tateo et al, 2019 , Noorimotlagh et al, 2021 , Bergamaschi et al, 2018 , Cortese et al, 2020 , Heydarpour et al, 2014 , Gregory et al, 2008 , Parolisi et al, 2021 , Jeanjean et al, 2018 ), it was reasonable to expect that the effects of pollution, widely documented in the general population, would have been confirmed or even further enhanced among MS patients and thus our results are not surprising. Among MS patients, air pollution can thus additionally contribute to the risk of unfavorable Covid-19 course, being a co-factor together with other well known risk factors for the general population (older age, higher BMI and presence of comorbidities) and for patients with MS (higher EDSS, progressive MS phenotype, disease duration and Anti-CD20 treatment).…”