This article was originally published here
Annu Rev Public Health. January 4, 2022. doi: 10.1146 / annurev-publhealth-052120-101420. Online ahead of print.
New evidence supports a link between environmental factors including air pollution and chemical exposures, climate and the built environment, and transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the sensitivity and severity of coronavirus disease 2019 (COVID-19). Climate, air pollution and the built environment have long been recognized as influencing viral respiratory infections, and studies have established similar associations with the results of COVID-19. More limited evidence links chemical exposures to COVID-19. Environmental factors have been found to influence COVID-19 through four main interconnected mechanisms: an increased risk of pre-existing conditions associated with disease severity; immune system deficiency; viral survival and transport; and behaviors that increase viral exposure. Data and methodological issues complicate the investigation of these relationships, including the reliance on coarse COVID-19 surveillance data; gaps in mechanistic studies; and the predominance of ecological designs. We assess the strength of the evidence for environment-COVID-19 relationships and discuss environmental actions that could simultaneously address the COVID-19 pandemic, environmental determinants of health, and health disparities. Final online publication date scheduled for Annual public health check-up, volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.