Skip to main content
PMC home page
Elsevier - PMC COVID-19 Collection logoLink to Elsevier - PMC COVID-19 Collection
letter
. 2020 Jun 23;741:140441. doi: 10.1016/j.scitotenv.2020.140441

Can exposure to PM2.5 particles increase the incidence of coronavirus disease 2019 (COVID-19)?

Khalid Mehmood a,⁎, Saifullah b, Muhammad Iqbal c, Muhammad Mohsin Abrar d
PMCID: PMC7308784  PMID: 32599406

Respiratory diseases caused by ambient air pollution are a contributing factor to prolonged bronchial inflammation leading eventually to hyper-activation of innate immune system, morbidity and mortality all over the world (Conticini et al., 2020; Liu et al., 2019). Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) is the pathogenic agent of the coronavirus disease (COVID-19), previously known as 2019 Novel Coronavirus (2019-nCoV) (Lu et al., 2020). Recently it has gained a global importance after its emergence from the Chinese city Wuhan in December 2019. COVID-19 causes rapidly developing acute respiratory distress syndrome (ARDS), acute respiratory failure, and other life-threatening diseases (Liu et al., 2019; WHO, 2020). The source of COVID-19 is still not confirmed; however, the initial cases were reported from Huanan South China Seafood Market, in Wuhan, China.

Currently, research regarding the clinical features and epidemiology of pneumonia caused by COVID-19 is limited. However, it is noted that the pollution of particulate matter ≤2.5 μm in diameter (PM2.5) impairs the first line of defense of the upper airways called cilia (Yongjian et al., 2020). Studies by Cui et al. (2003) conducted during the SARS epidemic in China revealed that SARS, caused by a virus genetically identical to COVID-19, lead to a high mortality rate in areas with deteriorated air quality. A substantial relationship seems to exist between PM2.5 and COVID-19 infection spread over 120 cities. A 10 μg m−3 increase in pollution concentration caused a statistically significant increase in daily counts of the confirmed Corona-positive cases. Wu et al. (2020) have suggested that an increase of just 1 μ gm−3 of PM2.5 corresponded to a 15% increase in COVID-19 deaths. Thus, populations exposed to a high concentration of PM2.5 particles are more prone to developing chronic respiratory diseases favorable to infective agents. Long-term exposure to PM2.5 develops a chronic inflammatory stimulus, especially in children and unhealthy population (Conticini et al., 2020), while a short-term PM2.5 exposure may also increase susceptibility to infections (Chen et al., 2020), because the particulate pollution damages human airways, potentially facilitating viral infections. Also, human exposure to PM2.5 pollutants weakens the immune response, making human body less effective in fighting against the virus-caused diseases (Chen et al., 2020; Li et al., 2019; Liu et al., 2019; Sedlmaier et al., 2009). In an experiment conducted in a small cohort of mice exposed for three months to PM2.5, interleukin-4 (IL-4), tumor necrosis factor (TNF-α) and transforming growth factor (TGF)-β1 were found to occur substantially in the lung parenchyma, leucocytes, macrophages and serum (Yang et al., 2019). Noticeably, a large systemic inflammation damages heart function too, as confirmed by another cohort of mice exposed to PM2.5 (Radan et al., 2019). All these phenomena have been extensively reported to occur in humans also, as PM2.5 is known to contribute to a systemic inflammation in healthy, non-smoker, and young populations (Pope et al., 2016). Apparently, both the short- and long-term PM2.5 exposures contribute to a higher incidence of lethality of COVID-19. According to the WHO official data on COVID-19, China is the first affected country by COVID-19, with more than 84,652 infected cases and 4645 deaths. Globally, COVID-19 cases are reported to be 8,750,480 with more than 461,813 deaths. According to the Chinese government's senior medical adviser, threat of a second wave of infections is looming large. We believe that epidemiological and experimental researches are urgently required to estimate the impact of PM2.5 incidence on the exposed population in almost every country. Further, the government and researchers of different countries should take into account the PM2.5 exposures in regions with higher levels of atmospheric pollution, while formulating policies to mitigate the incidence of COVID-19.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Editor: Jianmin Chen

References

  1. Chen N., Zhou M., Dong X., Qu J., Gong F., Han Y. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507–513. doi: 10.1016/S0140-6736(20)30211-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Conticini E., Frediani B., Caro D. Can atmospheric pollution be considered a co-factor in extremely high level of SARS-CoV-2 lethality in northern Italy? Environ. Pollut. 2020:114465. doi: 10.1016/j.envpol.2020.114465. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cui Y., Zhang Z.-F., Froines J., Zhao J., Wang H., Yu S.-Z. Air pollution and case fatality of SARS in the People’s Republic of China: an ecologic study. Environ. Health. 2003;2:15. doi: 10.1186/1476-069X-2-15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Li M., Wang Y., Ding F., Xu Y., Zhu P., Ding X. Dynamics of maize straw residue 13C incorporation into aggregates of a Mollisol as affected by long-term fertilization. J. Soils Sediments. 2019;19:1151–1160. [Google Scholar]
  5. Liu C., Chen R., Sera F., Vicedo-Cabrera A.M., Guo Y., Tong S. Ambient particulate air pollution and daily mortality in 652 cities. N. Engl. J. Med. 2019;381:705–715. doi: 10.1056/NEJMoa1817364. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Lu R., Zhao X., Li J., Niu P., Yang B., Wu H. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395:565–574. doi: 10.1016/S0140-6736(20)30251-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Pope C.A., III, Bhatnagar A., McCracken J.P., Abplanalp W., Conklin D.J., O’Toole T. Exposure to fine particulate air pollution is associated with endothelial injury and systemic inflammation. Circ. Res. 2016;119:1204–1214. doi: 10.1161/CIRCRESAHA.116.309279. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Radan M., Dianat M., Badavi M., Mard S.A., Bayati V., Goudarzi G. Gallic acid protects particulate matter (PM10) triggers cardiac oxidative stress and inflammation causing heart adverse events in rats. Environ. Sci. Pollut. Res. 2019;26:18200–18207. doi: 10.1007/s11356-019-05223-w. [DOI] [PubMed] [Google Scholar]
  9. Sedlmaier N., Hoppenheidt K., Krist H., Lehmann S., Lang H., Büttner M. Generation of avian influenza virus (AIV) contaminated fecal fine particulate matter (PM2.5): genome and infectivity detection and calculation of immission. Vet. Microbiol. 2009;139:156–164. doi: 10.1016/j.vetmic.2009.05.005. [DOI] [PubMed] [Google Scholar]
  10. WHO . 2020. Clinical Management of Severe Acute Respiratory Infection When Novel Coronavirus (2019-nCoV) Infection Is Suspected: Interim Guidance. Clinical Management of Severe Acute Respiratory Infection when Novel Coronavirus (2019-nCoV) Infection Is Suspected: Interim Guidance; p. 21. [Google Scholar]
  11. Wu X., Nethery R.C., Sabath B.M., Braun D., Dominici F. 2020. Exposure to Air Pollution and COVID-19 Mortality in the United States. medRxiv. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Yang J., Chen Y., Yu Z., Ding H., Ma Z. The influence of PM2.5 on lung injury and cytokines in mice. Exp. Ther. Med. 2019;18:2503–2511. doi: 10.3892/etm.2019.7839. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Yongjian Z., Jingu X., Fengming H., Liqing C. Association between short-term exposure to air pollution and COVID-19 infection: evidence from China. Sci. Total Environ. 2020:138704. doi: 10.1016/j.scitotenv.2020.138704. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from The Science of the Total Environment are provided here courtesy of Elsevier

RESOURCES