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Environ Chem Lett . Air pollution by NO 2 and PM 2.5 explains COVID-19 infection severity by overexpression of angiotensin-converting enzyme 2 in re

tetano

Editor, Senior Moderator
Environ Chem Lett


. 2020 Sep 18;1-18.
doi: 10.1007/s10311-020-01091-w. Online ahead of print.
Air pollution by NO [SUB]2[/SUB] and PM [SUB]2.5[/SUB] explains COVID-19 infection severity by overexpression of angiotensin-converting enzyme 2 in respiratory cells: a review


Biswaranjan Paital[SUP] 1 [/SUP], Pawan Kumar Agrawal[SUP] 2 [/SUP]



Affiliations

Abstract

Many major cities that witnessed heavy air pollution by nitrogen dioxide (NO[SUB]2[/SUB]) and particulate matter (PM) have experienced a high rate of infection and severity of the coronavirus disease pandemic (COVID-19). This phenomenon could be explained by the overexpression of the angiotensin converting enzyme 2 (ACE-2) on epithelial cell surfaces of the respiratory tract. Indeed, ACE-2 is a receptor for coronaviruses including the severe acute respiratory syndrome coronavirus 1 and 2 (SARS-CoV), and ACE-2 is overexpressed under chronic exposure to air pollution such as NO[SUB]2[/SUB] and PM[SUB]2.5[/SUB]. In this review, we explain that ACE-2 acts as the sole receptor for the attachment of the SARS-CoV-2 via its spike protein. The fact that respiratory and vascular epithelial cells express ACE-2 has been previously observed during the 2003 epidemic of the SARS-CoV-1 in China, and during the 2012 Middle East respiratory syndrome in Saudi Arabia. High ACE-2 expression in respiratory epithelial cells under air pollution explains the positive correlation between the severity in COVID-19 patients and elevated air pollution, notably high NO[SUB]2[/SUB] and PM[SUB]2.5[/SUB] levels. Specific areas in India, China, Italy, Russia, Chile and Qatar that experience heavy air pollution also show high rates of COVID-19 infection and severity. Overall, we demonstrate a link between NO[SUB]2[/SUB] emissions, PM[SUB]2.5[/SUB] levels, ACE-2 expression and COVID-19 infection severity. Therefore, air pollution should be reduced in places where confirmed cases of COVID-19 are unexpectedly high.

Keywords: Air pollution; Angiotensin converting enzyme 2 expression; COVID-19 severity; NO2 emissions; Particulate matters 2.5; environmental intervention.
 
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