Early Spread of COVID-19 in the Air-Polluted Regions of Eight Severely Affected Countries

  1. Riccardo Pansini
  2. Davide Fornacca

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Abstract

COVID-19 escalated into a pandemic posing several humanitarian as well as scientific challenges. We here investigated the geographical character of the early spread of the infection and correlated it with several annual satellite and ground indexes of air quality in China, the United States, Italy, Iran, France, Spain, Germany, and the United Kingdom. The time of the analysis corresponded with the end of the first wave infection in China, namely June 2020. We found more viral infections in those areas afflicted by high PM 2.5 and nitrogen dioxide values. Higher mortality was also correlated with relatively poor air quality. In Italy, the correspondence between the Po Valley pollution and SARS-CoV-2 infections and induced mortality was the starkest, originating right in the most polluted European area. Spain and Germany did not present a noticeable gradient of pollution levels causing non-significant correlations. Densely populated areas were often hotspots of lower air quality levels but were not always correlated with a higher viral incidence. Air pollution has long been recognised as a high risk factor for several respiratory-related diseases and conditions, and it now appears to be a risk factor for COVID-19 as well. As such, air pollution should always be included as a factor for the study of airborne epidemics and further included in public health policies.

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  1. Version published to 10.3390/atmos12060795
  2. Version published to 10.1101/2020.04.30.20086496v2 on medRxiv
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    SciScore for 10.1101/2020.04.30.20086496: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

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    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Despite these limitations, Iran and France show highly clustered COVID-19/pollution distributions, in the same manner as the Italian case, resulting in significant positive correlation that confirm our hypotheses. The absence of correlation found in Spain should be attributed to high levels of air quality, within the green Air Quality Index standard range, and ensuing minimal differences among its provinces. Moreover, the regions most affected by the virus seem to be those less densely populated, a peculiarity still not provided by the literature and requiring future investigation. In Germany, also, a clear correlation could not be detected because, inversely, pollution is widely spread across its districts. For these two countries, we therefore back up another report68 which finds high levels of NO2 associated with COVID-19 mortality in Spain and Germany. To note, though, that it is always necessary to control for population densities in these types of analysis69. Finally, in the U.K., where containment measures were implemented late, fatalities and mortality rates, but not cases alone, were correlated with air pollution, suggesting that when affected by the disease, a weakened respiratory system due to prolonged stress by air pollution increases the risk of mortality. Despite the highly significant correlations of these findings that we collected over three time periods in March54, April70 and, as reported here, end of May, their interpretation has to be necessary cautious....

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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  4. Version published to 10.1101/2020.04.30.20086496v1 on medRxiv