Air Pollution and Covid-19: The Role of Particulate Matter in the Spread and Increase of Covid-19's Morbidity and Mortality

Int J Environ Res Public Health. 2020 Jun 22;17(12):4487. doi: 10.3390/ijerph17124487.


Sars-cov-2 virus (Covid-19) is a member of the coronavirus family and is responsible for the pandemic recently declared by the World Health Organization. A positive correlation has been observed between the spread of the virus and air pollution, one of the greatest challenges of our millennium. Covid-19 could have an air transmission and atmospheric particulate matter (PM) could create a suitable environment for transporting the virus at greater distances than those considered for close contact. Moreover, PM induces inflammation in lung cells and exposure to PM could increase the susceptibility and severity of the Covid-19 patient symptoms. The new coronavirus has been shown to trigger an inflammatory storm that would be sustained in the case of pre-exposure to polluting agents. In this review, we highlight the potential role of PM in the spread of Covid-19, focusing on Italian cities whose PM daily concentrations were found to be higher than the annual average allowed during the months preceding the epidemic. Furthermore, we analyze the positive correlation between the virus spread, PM, and angiotensin-converting enzyme 2 (ACE2), a receptor involved in the entry of the virus into pulmonary cells and inflammation.

Keywords: ACE2; covid-19; inflammation; oxidative stress; particulate matter.

Publication types

  • Review

MeSH terms

  • Aerosols
  • Air Pollution / adverse effects*
  • Angiotensin-Converting Enzyme 2
  • Betacoronavirus*
  • COVID-19
  • Cities
  • Coronavirus Infections / mortality
  • Coronavirus Infections / transmission*
  • Coronavirus Infections / virology
  • Humans
  • Inflammation / etiology
  • Italy / epidemiology
  • Morbidity
  • Oxidative Stress
  • Pandemics
  • Particulate Matter*
  • Peptidyl-Dipeptidase A / metabolism
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / transmission*
  • Pneumonia, Viral / virology
  • SARS-CoV-2


  • Aerosols
  • Particulate Matter
  • Peptidyl-Dipeptidase A
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2