Graphical Abstract

The novel human coronavirus disease 2019 (COVID-19) pandemic has claimed more than 600,000 lives worldwide, causing tremendous public health, social, and economic damages. Although the risk factors of COVID-19 are still under investigation, environmental factors, such as urban air pollution, may play an important role in increasing population susceptibility to COVID-19 pathogenesis.

We conducted a cross-sectional nationwide study using zero-inflated negative binomial models to estimate the association between long-term (2010–2016) county-level exposures to NO2, PM2.5, and O3 and county-level COVID-19 case-fatality and mortality rates in the United States. We used both single- and multi-pollutant models and controlled for spatial trends and a comprehensive set of potential confounders, including state-level test positive rate, county-level health care capacity, phase of epidemic, population mobility, population density, sociodemographics, socioeconomic status, race and ethnicity, behavioral risk factors, and meteorology.

Cite this article

Liang, D., Shi, L., Zhao, J., Liu, P., Sarnat, J.A., Gao, S., Schwartz, J., Liu, Y., Ebelt, S.T., Scovronick, N. and Chang, H.H. Urban Air Pollution May Enhance COVID-19 Case-Fatality and Mortality Rates in the United States. The Innovation 1 (3), 100047 (2020). doi: 10.1016/j.xinn.2020.100047