Links between air pollution and COVID-19 in England

Marco Travaglio; Rebeka Popovic; Yizhou Yu; Nuno Leal; L. Miguel Martins

In our study, we found that high levels of two NOx, nitrogen dioxide and nitrogen oxide, correlate with increased COVID-19 mortality and spread in England. NOx gases result from a chemical reaction between nitrogen and oxygen during combustion of fossil fuels and, therefore, represent a significant source of air pollution in areas with high traffic 13 . Previous studies showed that exposure to nitrogen dioxide is associated with a significant decrease in pulmonary function and promotes an inflammatory response in the airway 14 15 16 . In fact, a recent study showed that intensive care unit (ICU) ventilation duration associates with preadmission exposure to nitrogen dioxide 17 . Furthermore, Faustini and colleagues 18 reported that a 10 µg/m3 increase in the annual concentration of nitrogen dioxide is associated with a 13% and 2% increase in cardiovascular and respiratory mortality, respectively. As respiratory and cardiovascular diseases represent potential risk factors associated with increased COVID-19 mortality, our results are in line with the hypothesis that long-term exposure to nitrogen dioxide is linked with increased risk of COVID-19 mortality.