Can atmospheric pollution be considered a co-factor in extremely high level of SARS-CoV-2 lethality in Northern Italy?

Environ Pollut. 2020 Jun:261:114465. doi: 10.1016/j.envpol.2020.114465. Epub 2020 Apr 4.


This paper investigates the correlation between the high level of Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) lethality and the atmospheric pollution in Northern Italy. Indeed, Lombardy and Emilia Romagna are Italian regions with both the highest level of virus lethality in the world and one of Europe's most polluted area. Based on this correlation, this paper analyzes the possible link between pollution and the development of acute respiratory distress syndrome and eventually death. We provide evidence that people living in an area with high levels of pollutant are more prone to develop chronic respiratory conditions and suitable to any infective agent. Moreover, a prolonged exposure to air pollution leads to a chronic inflammatory stimulus, even in young and healthy subjects. We conclude that the high level of pollution in Northern Italy should be considered an additional co-factor of the high level of lethality recorded in that area.

Keywords: ARDS; Atmospheric pollution; Coronavirus; Covid-19; Inflammation.

MeSH terms

  • Air Pollution / statistics & numerical data*
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / metabolism
  • Coronavirus Infections / mortality*
  • Cytokines / metabolism
  • Environmental Exposure / statistics & numerical data*
  • Humans
  • Italy / epidemiology
  • Pandemics
  • Pneumonia, Viral / metabolism
  • Pneumonia, Viral / mortality*
  • Respiratory Distress Syndrome / mortality
  • SARS-CoV-2


  • Cytokines