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Nitrogen dioxide pollution increases vulnerability to COVID-19 through altered immune function.

Agostino Di Ciaula1,2, Leonilde Bonfrate3, Piero Portincasa3

  • 1Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy. agodiciaula@gmail.com.

Environmental Science and Pollution Research International
|February 8, 2022
PubMed
Summary
This summary is machine-generated.

Previous exposure to nitrogen dioxide (NO2) air pollution is linked to increased COVID-19 mortality risk. This air pollutant negatively impacts immune cells, suggesting reduced pollution could be a key prevention strategy.

Keywords:
Air pollutionCOVID-19ElderlyLymphocyte subsetsLymphocytesMortalityNO2PM10SARS-CoV-2

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Area of Science:

  • Environmental Health
  • Immunology
  • Infectious Diseases

Background:

  • Ecological studies suggest links between air pollution and SARS-CoV-2 infection.
  • Individual-level data confirming these associations are limited.
  • Understanding these links is crucial for public health interventions.

Purpose of the Study:

  • To investigate the relationship between exposure to particulate matter (PM10) and nitrogen dioxide (NO2) and clinical outcomes in hospitalized COVID-19 patients.
  • To explore the impact of air pollutant exposure on lymphocyte subsets in COVID-19 patients.
  • To identify predictors of mortality in COVID-19 patients.

Main Methods:

  • Assessed individual exposure to PM10 and NO2 in the two weeks prior to hospital admission for 147 geocoded COVID-19 patients.
  • Analyzed clinical outcomes (discharge vs. in-hospital death) and lymphocyte subsets.
  • Utilized statistical analysis to identify independent predictors of mortality.

Main Results:

  • Patients who died in-hospital had higher previous exposure to NO2, but not PM10, compared to discharged patients.
  • In-hospital death was associated with neutrophilia, lymphopenia, and reduced numbers of T and B lymphocytes.
  • Age and previous NO2 exposure were independent predictors of mortality, with NO2 negatively correlating with CD45, CD3, and CD4 cell counts.

Conclusions:

  • Previous exposure to NO2 is an independent risk factor for mortality in COVID-19 patients, acting through detrimental immune effects.
  • Lymphopenia and altered lymphocyte subsets may be influenced by age and air pollution exposure prior to infection.
  • Reducing air pollution should be considered a primary preventive measure against SARS-CoV-2 infection and mortality.