Severe air pollution links to higher mortality in COVID-19 patients: The “double-hit” hypothesis.

Frontera, Antonio; Cianfanelli, Lorenzo; Vlachos, Konstantinos; Landoni, Giovanni; Cremona, George

doi:10.1016/j.jinf.2020.05.031

Cited by 249 publications

(275 citation statements)

References 28 publications

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“…If so, this should have afflicted Lombardy. Other researches instead assert that the virus's genetic mutations did not cause a mutation in its behavior [ 20 ]; if so, the greater Lombard virulence should find explanations in correlation with pollution, delay in lockdown, or other factors such as a major predisposition of the subjects to be infected and develop severe symptoms [ 10 , 21 ]. However, it must be considered that many of these scenarios could prove to be true simultaneously.…”

Section: Discussionmentioning

confidence: 99%

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Modeling the Epidemiological Trend and Behavior of COVID-19 in Italy

Rovetta¹,

Bhagavathula²,

Castaldo³

2020

Cureus

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As of May 14, 2020, Italy has been one of the red hotspots for the COVID-19 pandemic. In particular, the regions of Emilia Romagna, Piedmont, and especially Lombardy were the most affected and had to face very serious health emergencies, which brought them to the brink of collapse. Since the virus has demonstrated local properties, i.e., greater severity and contagiousness in specific regions, the aim of this study is to model the complex behavior of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Italy. In particular, we further investigated the results of other articles on the correlation with particulate matter pollution 10 (PM 10) and 2.5 (PM 2.5) by extending the research at the intra-regional level, as well as calculated a more plausible number of those infected compared to those officially declared by Civil Protection. Through a computational simulation of the Susceptible-Exposed-Infectious-Recovered (S.E.I.R.) model, we also estimated the most representative basic reproduction number \begin{document}R0\end{document} for these three regions from February 22 to March 14, 2020. In doing so, we have been able to evaluate the consistency of the first containment measures until the end of April, as well as identify possible SARS-CoV-2 local behavior mutations and specificities.

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Section: Discussionmentioning

confidence: 99%

“…While other studies have been conducted on the PM 2.5 - novel coronavirus correlation at the national level, we have focused exclusively on the Lombardy region, analyzing the data of all the monitoring units of all the provinces through the previously defined \begin{document}\rho\end{document} correlation matrix [ 10 ].…”

Section: Methodsmentioning

confidence: 99%

Modeling the Epidemiological Trend and Behavior of COVID-19 in Italy

Rovetta¹,

Bhagavathula²,

Castaldo³

2020

Cureus

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“…In any case, it will be interesting to explore if pollutants can interact with COVID-19 infection to further increase the inflammatory cascade, a main culprit in the onset of acute CV events. Of interest, a recent study proposed an exciting theory on the association between pollution, COVID-19, and its impact on the high rate of infection and mortality, plausibly higher in more susceptible patients presenting pre-existing CV disease [ 78 ]. Since chronic exposure to PM 2.5 in mice causes up-regulation of pulmonary ACE expression and activity, in patients exposed to pollutants, viral entry could be facilitated and increased viral load could result in depletion of ACE-2 receptors (through binding of SARS-CoV-2 Spike protein to ACE2) and impairment of host defenses [ 79 ].…”

Section: Possible Causal Links Between Covid-19 Infection and Amimentioning

confidence: 99%

“Acute Myocardial Infarction in the Time of COVID-19”: A Review of Biological, Environmental, and Psychosocial Contributors

Gorini

Chatzianagnostou

Mazzone

et al. 2020

IJERPH

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Coronavirus disease 2019 (COVID-19) has quickly become a worldwide health crisis.Although respiratory disease remains the main cause of morbidity and mortality in COVID patients,myocardial damage is a common finding. Many possible biological pathways may explain therelationship between COVID-19 and acute myocardial infarction (AMI). Increased immune andinflammatory responses, and procoagulant profile have characterized COVID patients. All theseresponses may induce endothelial dysfunction, myocardial injury, plaque instability, and AMI.Disease severity and mortality are increased by cardiovascular comorbidities. Moreover, COVID-19has been associated with air pollution, which may also represent an AMI risk factor. Nonetheless,a significant reduction in patient admissions following containment initiatives has been observed,including for AMI. The reasons for this phenomenon are largely unknown, although a real decreasein the incidence of cardiac events seems highly improbable. Instead, patients likely may presentdelayed time from symptoms onset and subsequent referral to emergency departments because offear of possible in-hospital infection, and as such, may present more complications. Here, we aim todiscuss available evidence about all these factors in the complex relationship between COVID-19and AMI, with particular focus on psychological distress and the need to increase awareness ofischemic symptoms.

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“…In European cities like Barcelona, NO 2 concentrations were reduced by half during the lockdown, PM decreased lower, and O 3 concentrations increased by around 50% [ 14 ]. PM 2.5 deterioration of air quality may lead to various kinds of pulmonary and cardiovascular diseases causing premature death [ 15 ]. In addition, there are several studies that indicate cities with poorer outdoor air quality have had a higher death rate in those affected by COVID-19 [ 16 , 17 , 18 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Bad Air Can Also Kill: Residential Indoor Air Quality and Pollutant Exposure Risk during the COVID-19 Crisis

Domínguez-Amarillo

Fernández-Agüera

Cesteros-García

et al. 2020

IJERPH

102

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During the first outbreak of the SARS-CoV-2 pandemic the population, focusing primarily on the risk of infection, was generally inattentive to the quality of indoor air. Spain, and the city of Madrid in particular, were among the world’s coronavirus hotspots. The country’s entire population was subject to a 24/7 lockdown for 45 days. This paper describes a comparative longitudinal survey of air quality in four types of housing in the city of Madrid before and during lockdown. The paper analysed indoor temperatures and variations in CO2, 2.5 μm particulate matter (PM2.5) and total volatile organic compound (TVOC) concentrations before and during lockdown. The mean daily outdoor PM2.5 concentration declined from 11.04 µg/m3 before to 7.10 µg/m3 during lockdown. Before lockdown the NO2 concentration values scored as ‘very good’ 46% of the time, compared to 90.9% during that period. Although the city’s outdoor air quality improved, during lockdown the population’s exposure to indoor pollutants was generally more acute and prolonged. Due primarily to concern over domestic energy savings, the lack of suitable ventilation and more intensive use of cleaning products and disinfectants during the covid-19 crisis, indoor pollutant levels were typically higher than compatible with healthy environments. Mean daily PM2.5 concentration rose by approximately 12% and mean TVOC concentration by 37% to 559%. The paper also puts forward a series of recommendations to improve indoor domestic environments in future pandemics and spells out urgent action to be taken around indoor air quality (IAQ) in the event of total or partial quarantining to protect residents from respiratory ailments and concomitantly enhanced susceptibility to SARS-CoV-2, as identified by international medical research.

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Severe air pollution links to higher mortality in COVID-19 patients: The “double-hit” hypothesis.

Cited by 249 publications

References 28 publications

Modeling the Epidemiological Trend and Behavior of COVID-19 in Italy

Modeling the Epidemiological Trend and Behavior of COVID-19 in Italy

“Acute Myocardial Infarction in the Time of COVID-19”: A Review of Biological, Environmental, and Psychosocial Contributors

Bad Air Can Also Kill: Residential Indoor Air Quality and Pollutant Exposure Risk during the COVID-19 Crisis

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