Exposure to high levels of air pollution linked to severe COVID-19: study

Story at a glance


  • New research conducted by Berlin scientists says that COVID-19 patients living in areas with higher levels of NO2 are more likely to need ICU care or mechanical ventilation.


  • The research has not been peer reviewed yet but is being presented at Euroanaesthesia, an annual meeting of the European Society of Anesthesiology and Intensive Care, taking place in Italy.


  • Even though the research does not prove causation, it does suggest a possible answer to increased need for ICU care and mechanical ventilation among COVID-19 patients in more polluted parts of Germany.


New research has found a connection between long-term air pollution exposure and a higher chance of developing severe COVID-19.

The study, published Monday, found that people in German counties with higher levels of nitrogen dioxide were more likely to be admitted to the Intensive Care Unit and need mechanical ventilation if they had COVID-19.

Long-term exposure to nitrogen dioxide, a potent greenhouse gas emitted from fossil fuel combustion, can harm lung-function, contribute to the development of asthma and lower resistance to respiratory infections, according to the Environmental Protection Agency.


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The research, yet to be peer reviewed, will be presented this week at Euroanaesthesia, the annual meeting of the European Society of Anesthesiology and Intensive Care (ESAIC) in Milan, Italy. Researchers at the Charite– Universitatsmedizin Berlin used data from the German Interdisciplinary Association for Intensive Care and Emergency Medicine registry, which was set up to track hospital ICU capacity during the pandemic.

Examining a month of data from nearly all German counties, researchers concluded that long-term exposure to nitrogen dioxide before the pandemic was linked to more patients requiring ICU care and mechanical ventilation to treat COVID-19.

To calculate annual mean nitrogen dioxide levels, researchers examined data on German air pollution from 2010 to 2019 and found that county mean levels ranged from 4.6 micrograms per cubic meter to 32 micrograms per cubic meter.

Frankfurt had the highest level of nitrogen dioxide, while the small city of Suhl had the lowest amount.

With every additional 1 microgram per cubic meter of nitrogen dioxide in the air there was a 3.2 percent increase in the number of ICU beds needed for COVID-19 patients and a 3.5 percent increase in the number of hospitalized people with the virus needing mechanical ventilation.

The research states that in the 10 counties with the lowest long-term nitrogen dioxide levels, an average of 28 ICU beds and 19 ventilators were needed for COVID-19 patients during the month studied.

Meanwhile, in the 10 counties with the highest long-term nitrogen dioxide levels, 144 ICU beds and 102 ventilators were needed during that same time period on average.

While the results do not necessarily prove causation, they do point to a potential explanation, scientists say, according to Medical News.

It also supports earlier research, including a Harvard study that linked prolonged air pollution with an 11 percent increase in people dying from COVID-19 for every 1 microgram per cubic meter more of air pollution.


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