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Annu Rev Public Health
. 2022 Jan 4.
doi: 10.1146/annurev-publhealth-052120-101420. Online ahead of print.
Environmental Factors Influencing COVID-19 Incidence and Severity
Amanda K Weaver 1 , Jennifer R Head 2 , Carlos F Gould 3 4 , Elizabeth J Carlton 5 , Justin V Remais 1
Affiliations
- PMID: 34982587
- DOI: 10.1146/annurev-publhealth-052120-101420
Abstract
Emerging evidence supports a link between environmental factors-including air pollution and chemical exposures, climate, and the built environment-and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and coronavirus disease 2019 (COVID-19) susceptibility and severity. Climate, air pollution, and the built environment have long been recognized to influence viral respiratory infections, and studies have established similar associations with COVID-19 outcomes. More limited evidence links chemical exposures to COVID-19. Environmental factors were found to influence COVID-19 through four major interlinking mechanisms: increased risk of preexisting conditions associated with disease severity; immune system impairment; viral survival and transport; and behaviors that increase viral exposure. Both data and methodologic issues complicate the investigation of these relationships, including reliance on coarse COVID-19 surveillance data; gaps in mechanistic studies; and the predominance of ecological designs. We evaluate the strength of evidence for environment-COVID-19 relationships and discuss environmental actions that might simultaneously address the COVID-19 pandemic, environmental determinants of health, and health disparities. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.