Advertisement

Air pollution, racial disparities, and COVID-19 mortality

  • Eric B. Brandt
    Affiliations
    Division of Asthma Research, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
    Search for articles by this author
  • Andrew F. Beck
    Affiliations
    Divisions of General and Community Pediatrics and Hospital Medicine, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
    Search for articles by this author
  • Tesfaye B. Mersha
    Correspondence
    Corresponding author: Tesfaye B. Mersha, PhD, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati, 3333 Burnet Ave, MLC 7037, Cincinnati, OH 45229.
    Affiliations
    Division of Asthma Research, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
    Search for articles by this author
      Since late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected millions of people worldwide and resulted in more than 200,000 coronavirus disease 2019 (COVID-19) deaths. Emerging data suggest that elderly people as well as individuals with underlying health conditions are at a higher risk of hospitalization and death.
      • Guan W.J.
      • Ni Z.Y.
      • Hu Y.
      • Liang W.H.
      • Ou C.Q.
      • He J.X.
      • et al.
      Clinical characteristics of coronavirus disease 2019 in China.

      Pansini R, Fornacca D. Initial evidence of higher morbidity and mortality due to SARS-CoV-2 in regions with lower air quality [published online ahead of print April 16, 2020]. medRxiv. https://doi.org/10.1101/2020.04.04.20053595.

      Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China [published online ahead of print March 13, 2020]. JAMA Intern Med. https://doi.org/10.1001/jamainternmed.2020.0994.

      Interestingly, the Centers for Disease Control and Prevention’s list of risk factors for severe COVID-19 (Fig 1) largely overlap with the list of diseases that are known to be worsened by chronic exposure to air pollution, including diabetes, heart diseases, and chronic airway diseases, such as asthma, lung cancer, and chronic obstructive pulmonary disease.

      Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China [published online ahead of print March 13, 2020]. JAMA Intern Med. https://doi.org/10.1001/jamainternmed.2020.0994.

      In this editorial, we highlight potential links between exposure to air pollution and COVID-19 severity, and we also hypothesize that disparate exposure to air pollution is one of the factors that contribute to the disproportionate impact COVID-19 is having on inner-city racial minorities.
      Figure thumbnail gr1
      Fig 1Impact of air pollution and racial disparities on COVID-19 mortality. Racial breakdown of COVID-19 data as of April 24, 2020, was obtained from APM Research Lab (https://www.apmresearchlab.org/covid/deaths-by-race). Additional racial disparity sources: https://www.washingtonpost.com/nation/2020/04/07/coronavirus-is-infecting-killing-black-americans-an-alarmingly-high-rate-post-analysis-shows/; https://www.nytimes.com/2020/04/08/nyregion/coronavirus-race-deaths.html; http://www.chicagotribune.com/coronavirus/ct-coronavirus-chicago-coronavirus-deaths-demographics-lightfoot-20200406-77nlylhiavgjzb2wa4ckivh7mu-story.html. Average PM2.5 concentrations (g/m3) for the years 2000 to 2016 were obtained from Atmospheric Composition Analysis (http://fizz.phys.dal.ca/∼atmos/martin). Figures were created by merging county-level data in a given state. The county-level COVID-19 death counts, adjusted for a population of 1 million, as of April 24, 2020, were obtained from Johns Hopkins University COVID-19 Case Tracker: https://coronavirus.jhu.edu. COVID-19 risk factors are based on Centers for Disease Control and Prevention’s insights (https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html). COPD, Chronic obstructive pulmonary disease.

      Key words

      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to Journal of Allergy and Clinical Immunology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Guan W.J.
        • Ni Z.Y.
        • Hu Y.
        • Liang W.H.
        • Ou C.Q.
        • He J.X.
        • et al.
        Clinical characteristics of coronavirus disease 2019 in China.
        N Engl J Med. 2020; 382: 1708-1720
      1. Pansini R, Fornacca D. Initial evidence of higher morbidity and mortality due to SARS-CoV-2 in regions with lower air quality [published online ahead of print April 16, 2020]. medRxiv. https://doi.org/10.1101/2020.04.04.20053595.

      2. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China [published online ahead of print March 13, 2020]. JAMA Intern Med. https://doi.org/10.1001/jamainternmed.2020.0994.

        • Cohen A.J.
        • Brauer M.
        • Burnett R.
        • Anderson H.R.
        • Frostad J.
        • Estep K.
        • et al.
        Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015.
        Lancet. 2017; 389: 1907-1918
        • Cui Y.
        • Zhang Z.F.
        • Froines J.
        • Zhao J.
        • Wang H.
        • Yu S.Z.
        • et al.
        Air pollution and case fatality of SARS in the People's Republic of China: an ecologic study.
        Environ Health. 2003; 2: 15
      3. Yao Y, Pan J, Liu Z, Meng X, Wang W, Kan H, et al. Ambient nitrogen dioxide pollution and spread ability of COVID-19 in Chinese cities [published online ahead of print April 10, 2020]. medRxiv. https://doi.org/10.1101/2020.03.31.20048595.

      4. Yao Y, Pan J, Liu Z, Meng X, Wang W, Kan H, et al. Temporal association between particulate matter pollution and case fatality rate of COVID-19 in Wuhan, China [published online ahead of print April 10, 2020]. medRxiv. https://doi.org/10.1101/2020.04.09.20049924.

        • Fattorini D.
        • Regoli F.
        Role of the chronic air pollution levels in the Covid-19 outbreak risk in Italy.
        Environ Pollut. 2020; ([Epub ahead of print]): 114732https://doi.org/10.1016/j.envpol.2020.114732
      5. Wu X, Nethery R, Sabath B, Braun D, Dominici F. Exposure to air pollution and COVID-19 mortality in the United States [published online ahead of print April 27, 2020]. medRxiv. https://doi.org/10.1101/2020.04.05.20054502.

        • Tessum C.W.
        • Apte J.S.
        • Goodkind A.L.
        • Muller N.Z.
        • Mullins K.A.
        • Paolella D.A.
        • et al.
        Inequity in consumption of goods and services adds to racial-ethnic disparities in air pollution exposure.
        Proc Natl Acad Sci U S A. 2019; 116: 6001-6006