Issue 4 – Impact of air pollution on COVID-19 mortality and morbidity: An epidemiological and mechanistic review.

Publication date: Dec 31, 2025

Air pollution is a major global environment and health concern. Recent studies have suggested an association between air pollution and COVID-19 mortality and morbidity. In this context, a close association between increased levels of air pollutants such as particulate matter ≤2. 5 to 10 uM, ozone and nitrogen dioxide and SARS-CoV-2 infection, hospital admissions and mortality due to COVID 19 has been reported. Air pollutants can make individuals more susceptible to SARS-CoV-2 infection by inducing the expression of proteins such as angiotensin converting enzyme (ACE)2 and transmembrane protease, serine 2 (TMPRSS2) that are required for viral entry into the host cell, while causing impairment in the host defence system by damaging the epithelial barrier, muco-ciliary clearance, inhibiting the antiviral response and causing immune dysregulation. The aim of this review is to report the epidemiological evidence on impact of air pollutants on COVID 19 in an up-to-date manner, as well as to provide insights on in vivo and in vitro mechanisms.

Concepts Keywords
Angiotensin ACE2 protein, human
Antiviral Air Pollutants
Host Air Pollutants
Muco Air Pollution
Viral Air pollution
Airways
Angiotensin-Converting Enzyme 2
Angiotensin-Converting Enzyme 2
COVID-19
COVID-19 mortality
Humans
Meteorological parameters
Morbidity
Nitrogen Dioxide
Nitrogen Dioxide
Ozone
Ozone
Particulate Matter
Particulate Matter
SARS-CoV-2
Serine Endopeptidases
Serine Endopeptidases
TMPRSS2 protein, human
Underlying mechanisms

Semantics

Type Source Name
drug DRUGBANK Medical air
disease MESH COVID-19
disease MESH morbidity
drug DRUGBANK Ozone
pathway REACTOME SARS-CoV-2 Infection
disease IDO host

Original Article

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