The COVID-19/SARS-CoV-2 pandemic struck health, social and economic systems worldwide, and represents an open challenge for scientists —coping with the high inter-individual variability of COVID-19, and for policy makers —coping with the responsibility to understand environmental factors affecting its severity across different geographical areas. Air pollution has been warned of as a modifiable factor contributing to differential SARS-CoV-2 spread but the biological mechanisms underlying the phenomenon are still unknown. Air quality and COVID-19 epidemiological data from 110 Italian provinces were studied by correlation analysis, to evaluate the association between particulate matter (PM)_2.5 concentrations and incidence, mortality rate and case fatality risk of COVID-19 in the period 20 February–31 March 2020. Bioinformatic analysis of the DNA sequence encoding the SARS-CoV-2 cell receptor angiotensin-converting enzyme 2 (ACE-2) was performed to identify consensus motifs for transcription factors mediating cellular response to pollutant insult. Positive correlations between PM_2.5 levels and the incidence (r = 0.67, p < 0.0001), the mortality rate (r = 0.65, p < 0.0001) and the case fatality rate (r = 0.7, p < 0.0001) of COVID-19 were found. The bioinformatic analysis of the ACE-2 gene identified nine putative consensus motifs for the aryl hydrocarbon receptor (AHR). Our results confirm the supposed link between air pollution and the rate and outcome of SARS-CoV-2 infection and support the hypothesis that pollution-induced over-expression of ACE-2 on human airways may favor SARS-CoV-2 infectivity.

中文翻译：

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探索 SARS-CoV-2 大流行与空气污染之间关系的循证考虑：PM2.5 介导的病毒受体 ACE-2 上调的参与。


COVID-19/SARS-CoV-2 大流行袭击了全世界的健康、社会和经济系统，对科学家来说是一个公开的挑战——应对 COVID-19 的个体间高度变异性，对政策制定者来说则是一个公开的挑战——应对责任了解不同地理区域影响其严重程度的环境因素。人们警告称，空气污染是导致 SARS-CoV-2 传播差异的一个可改变因素，但该现象背后的生物学机制仍不清楚。通过相关分析对意大利 110 个省份的空气质量和 COVID-19 流行病学数据进行研究，以评估 2 月 20 日至 31 日期间颗粒物 (PM) _2.5浓度与 COVID-19 发病率、死亡率和病死风险之间的关联2020 年 3 月。对编码 SARS-CoV-2 细胞受体血管紧张素转换酶 2 (ACE-2) 的 DNA 序列进行生物信息学分析，以确定介导细胞对污染物损伤反应的转录因子的共有基序。 PM _2.5水平与 COVID-19 的发病率（r = 0.67， p < 0.0001）、死亡率（r = 0.65， p < 0.0001）和病死率（r = 0.7， p < 0.0001）之间呈正相关。成立。 ACE-2 基因的生物信息学分析确定了芳烃受体 (AHR) 的九个假定共有基序。我们的结果证实了空气污染与 SARS-CoV-2 感染率和结果之间的假设联系，并支持了这样的假设：污染引起的人类呼吸道上 ACE-2 的过度表达可能有利于 SARS-CoV-2 的感染。