Enhancement of respiratory virus infection by air pollutants

Viral respiratory infections are a leading cause of morbidity and mortality worldwide, posing significant economic and health burdens. This review examines how air pollutants promote viral respiratory infections and influence disease outcomes. Papers published within the last 15 years regarding interactions between air pollutants and respiratory viruses were systematically identified and reviewed. The current evidence shows that common air pollutants can aggravate viral respiratory infections, either by assisting the spread, entry, and penetration of respiratory viruses to facilitate infection, or by interfering with host immune responses to heighten the risk of worse outcomes after infection. Moreover, air pollutants are known to increase the incidence of chronic obstructive pulmonary disease (COPD), diabetes, and asthma, which may weaken the effectiveness of the immune system against viral infections and increase the risks of excessive inflammation or cytokine storms. In addition, air pollutants can penetrate deep into the lower respiratory tract and various organs through the blood-air exchange system, leading to severe pulmonary and systemic adverse effects. In conclusion, air pollutants can affect a wide range of physiological aspects to exacerbate the impact of viral respiratory infections, and further research is critically needed to understand the underlying dynamics.