The novel human coronavirus disease 2019 (COVID-19) pandemic has claimed more than 600,000 lives worldwide, causing tremendous public health, social, and economic damages. Although the risk factors of COVID-19 are still under investigation, environmental factors, such as urban air pollution, may play an important role in increasing population susceptibility to COVID-19 pathogenesis.
From January 22, 2020, to July 17, 2020, 3,659,828 COVID-19 cases and 138,552 deaths were reported in 3,076 US counties, with an overall observed case-fatality rate of 3.8%. County-level average NO2 concentrations were positively associated with both COVID-19 case-fatality rate and mortality rate in single-, bi-, and tri-pollutant models. When adjusted for co-pollutants, per interquartile-range (IQR) increase in NO2 (4.6 ppb), COVID-19 case-fatality rate and mortality rate were associated with an increase of 11.3% (95% CI 4.9%–18.2%) and 16.2% (95% CI 8.7%–24.0%), respectively. We did not observe significant associations between COVID-19 case-fatality rate and long-term exposure to PM2.5 or O3, although per IQR increase in PM2.5 (2.6 μg/m3) was marginally associated, with a 14.9% (95% CI 0.0%–31.9%) increase in COVID-19 mortality rate when adjusted for co-pollutants.

Published Sep 21, 2020

Liang, D., Shi, L., Zhao, J., Liu, P., Sarnat, J. A., Gao, S., Schwartz, J., Liu, Y., Ebelt, S. T., Scovronick, N., & Chang, H. H. (2020). Urban Air Pollution May Enhance COVID-19 Case-Fatality and Mortality Rates in the United States. The Innovation, 1(3), 100047. https://doi.org/10.1016/j.xinn.2020.100047