Air Pollution Can up the Risk of Severe COVID-19: Study

Nitrogen Dioxide, a harmful greenhouse gas can worsen COVID-19 symptoms finds a study conducted in Germany.

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Nitrogen Dioxide and Coronavirus together make a deadly combo, quite literally.

A recent study conducted in Germany has found that people who come from places with high levels of atmospheric pollutant nitrogen dioxide are more likely to require intensive care units (ICUs) or medical ventilation when they contract COVID.

Patients of COVID-19 who have been exposed to air pollution for long periods of time have a significantly higher chance of developing severe symptoms, found the study.

Why is Nitrogen Dioxide Harmful?

When fossil fuels are burned, harmful gases are released into the atmosphere, one of which is nitrogen dioxide.

This particular gas damages the endothelial cells (that form a thin membrane, lining the inside of the heart and blood vessels), inhibiting the transfer of oxygen to a person's blood.

Nitrogen Dioxide, a harmful greenhouse gas can worsen COVID-19 symptoms finds a study conducted in Germany.

Air pollution has been on the rise around the globe, and gases like nitrogen dioxide are a bigger threat to us, now more than ever. 

(Photo: iStock)

"Our results show a positive association between long-term nitrogen dioxide exposure and Covid-19 fatality and Covid-19 incidence rate”
Susanne Koch, Head Researcher, Universitätsmedizin Berlin, as quoted by the Guardian

What the Study Found

Susanne Koch's team of researchers at Universitätsmedizin Berlin collected air pollution data from all counties in Germany, and ranked them according to the average levels of nitrogen dioxide in each county.

The study results which were presented last week to Euroanaesthesia, the annual meeting of the European Society of Anesthesiology and Intensive Care in Milan, showed Frankfurt as the most dangerous, and Suhl (Thuringia) had the lowest level of polluted air.

The group then studied the number of patients with severe COVID in Germany during a one month-period of 2020 who needed intensive care or mechanical ventilation. Extraneous factors were adjusted and findings were combined.

After the analysis, the team reported that, on one hand, an average of 28 ICU beds and 19 ventilators were needed for COVID patients in each of the 10 counties that had the lowest long-term nitrogen dioxide exposure while on the other, an average of 144 ICU beds and 102 ventilators were required in the 10 counties with the highest long-term exposure.

The researchers admitted that the study did not conclusively establish a direct link between air pollution and severe COVID, but strongly suggested the plausibility of one.

The Science Behind The Link

Nitrogen Dioxide, a harmful greenhouse gas can worsen COVID-19 symptoms finds a study conducted in Germany.

A visual of a covid mutation and how it forms a bond. 

(Photo: iStock)

The SARS COVID-19 virus is known to bind to the Ace-2 receptor when it enters cells after infecting a person.


This receptor has many important functions, including helping the body regulate levels of angiotensin II, a protein that increases inflammation. In other words, Ace-2 helps curb inflammation.

However, when COVID bonds with Ace-2, these brakes stop working. Air pollution is also known to cause a similar release of angiotensin II controls. Therefore, the combination of COVID and prolonged exposure to air pollution would result in more severe inflammation, more severe COVID, and a greater need for intensive care units and mechanical ventilation, the team argued.

Implications and Concerns

The implications of this study are alarming to say the least. Most countries around the globe have a high percent of nitrogen dioxide in their air.

Koch further added that a long-term exposure to such gases could cause heart diseases, asthma, or severe lung complications even after the ending of the pandemic.

Thus, the world finds itself at an urgent need to transition to cleaner cities, greener transport and renewable energy.

A greenpeace study testified that India houses 3 of the world's largest nitrogen-dioxide emission hotspots- Delhi-NCR, Sonbhadra in Uttar Pradesh; Singrauli in Madhya Pradesh and Talcher-Angul in Odisha.

For the safety and well-being of its citizens, India desperately needs to step up its pollution game, and soon.

A shift to sustainability is necessary to improve the quality of life for citizens everywhere.

(Written with inputs from the Guardian and PTI.)

(At The Quint, we are answerable only to our audience. Play an active role in shaping our journalism by becoming a member. Because the truth is worth it.)

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Topics:  Air Pollution   coronavirus   COVID-19 

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