Here’s How Air Pollution is Making the COVID-19 Battle Tougher

There has been a steady increase in the number of covid cases coming to the hospital. Not only there is an increase in number, but the severity has also increased.

Patients are more symptomatic, presenting with severe respiratory distress and low oxygen. Most of the ICU beds are full, as patients require strict monitoring and non-invasive and sometimes invasive ventilator support,

Though there could be many factors leading to this sudden surge in COVID cases like overcrowding due to festival season, lack of social distancing, poor hand hygiene but worsening of air quality has probably lead to increase in severity of cases. The pollutants in the air are known to reduce the immune response of the respiratory system, thereby affecting more people. Pollutants inflame the respiratory tract and down-regulates the immunity of the respiratory mucosa making people more susceptible to the infection as SARS-CoV-2 mainly attacks respiratory tract.

We all know exposure to air pollution increase the risk of the respiratory ailments and the COVID-19 infection also affects predominantly respiratory system.

Hence covid 19 patients will be more vulnerable & susceptible to suffer sever forms if exposed to polluted environment.

We are also aware that pollution especially smaller particles i.e. PM2.5 can cause lung damage and even enter our bloodstream affecting almost every organ in our body. These patients are more prone to suffer from diseases like COPD, Cancer, Heart ailments, hypertension etc. We also realise that patients with these comorbidities are liable to have severe manifestations of COVID 19 if they catch it.

One of the recent study, published in Cardiovascular Research estimated that about 15% of deaths worldwide from COVID-19 could be attributed to long-term exposure to air pollution. Another study published by Harvard group found that an increase of only 1μg/m3 in PM2.5 particles is associated with an increase in the Covid-19 death rate. A study from Italy shows that higher mortality was reported from regions, where air pollution levels were high. The mortality rate in northern Italy where pollution levels are higher was calculated at 12% as compared to other parts of Italy where it was around 4.5%.

Another problem is when one has respiratory symptoms like dry cough or sore throat which can co-exist with allergies, pollution and COVID-19. Many times it’s difficult to attribute the cause and there is a challenge to treat it.

Would you like to perform RTPCR on everyone who comes to you with these symptoms in this polluted environment?

On the other hand would one like to wait for more specific COVID symptoms to appear and then start the treatment as we are all aware that delay in initiating the treatment might worsen the symptoms. Though apart from a sore throat, pollution can cause a host of other symptoms like eye infections, headaches, cold, runny nose and postnasal drips where we can rule out COVID infection to some extent. On the other hand loss of taste & smell is quite specific to COVID infection.

There also have been theories that particulate matter might assist in transmission of COVID infection. We are aware that SARS COV2 virus is mainly transmitted through droplets spread by an infected person while coughing, sneezing or even talking. These droplets may settle on the particulate matter and remain in the air for longer period.

This will lead to more chance of transmitting the infection when the pollution levels go up. A study conducted in Italy also suggested that high concentrations of particulate matter could result in the virus forming clusters. No doubt all these studies teach us to curb pollution which would not only save us from COVID infection, but also from many other life-threatening infections.

We are all facing a huge problem in the form of COVID infection. We must do everything to reduce the morbidity & mortality caused by it. Pollution apart from causing innumerable ill effects in our body since ages has also been seen as an additional force in worsening COVID infection. The time has come where all measures to prevent COVID infection should also include reducing pollution level in our surroundings.

(Dr. Sandeep Nayar, Sr. Director and Head, Centre for Chest and Respiratory Disease, BLK Super Speciality Hospital)