Links between air pollution and COVID-19 in England

In December 2019, a novel disease, coronavirus disease 19 (COVID-19), emerged in Wuhan, People’s Republic of China. COVID-19 is caused by a novel coronavirus (SARS-CoV-2) presumed to have jumped species from another mammal to humans. This virus has caused a rapidly spreading global pandemic. To date, thousands of cases of COVID-19 have been reported in England, and over 25,000 patients have died. While progress has been achieved in managing this disease, the factors in addition to age that affect the severity and mortality of COVID-19 have not been clearly identified. Recent studies of COVID-19 in several countries identified links between air pollution and death rates. Here, we explored potential links between major air pollutants related to fossil fuels and SARS-CoV-2 mortality in England. We compared current SARS-CoV-2 cases and deaths recorded in public databases to both regional and subregional air pollution data monitored at multiple sites across England. We show that the levels of multiple markers of poor air quality, including nitrogen oxides and sulphur dioxide, are associated with increased numbers of COVID-19-related deaths across England, after adjusting for population density. We expanded our analysis using individual-level data from the UK Biobank and showed that particulate matter contributes to increased infectivity. We also analysed the relative contributions of individual fossil fuel sources on key air pollutant levels. The levels of some air pollutants are linked to COVID-19 cases and adverse outcomes. This study provides a useful framework to guide health policies in countries affected by this pandemic.