Publication date: Dec 01, 2025
Studies suggest ambient air pollution increases risk of individual-level adverse COVID-19 outcomes. Our review seeks to understand how air pollution influences adverse COVID-19 outcomes, by identifying how researchers accounted for cardiovascular morbidity, a predominant COVID-19 risk factor that is strongly linked to air pollution exposure. Our review primarily consisted of retrospective cohorts from the US and Europe, that examined both historical and short-term air pollution. Studies typically found that air pollution was associated with greater risk of individual-level adverse COVID-19 outcomes and adjusted for cardiovascular morbidities as confounders. Few hypothesized cardiovascular morbidity as a mediator or effect modifier in this relationship. Improved understanding of cardiovascular morbidity’s potential role as an effect modifier or mediator can help better explain the link between air pollution and COVID-19, in addition to identifying and assisting populations that may be at greater risk for adverse pandemic outcomes.
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| Concepts | Keywords |
|---|---|
| Cardiovascular | Air pollution |
| Covid | Cardiovascular morbidity |
| Europe | COVID-19 |
| Pandemic | Environmental exposure |
| Retrospective | Infectious disease severity |