Impact of COVID-19 Pandemic on Air Quality: A Systematic Review

The impact of air quality on cardiovascular health: A state of the art review

Air pollution is a global health challenge, increasing the risk of cardiovascular diseases such as heart disease, stroke, and arrhythmias. Particulate matter (PM), particularly PM2.5 and ultrafine particles (UFP), is a key contributor to the adverse effects of air pollution on cardiovascular health. PM exposure can lead to oxidative stress, inflammation, atherosclerosis, vascular dysfunction, cardiac arrhythmias, and myocardial injury. Reactive oxygen species (ROS) play a key role in mediating these effects. PM exposure can also lead to hypertension, a significant risk factor for cardiovascular disease. The COVID-19 pandemic resulted in a significant reduction of air pollutants, leading to a decline in the incidence of heart attacks and premature deaths caused by cardiovascular diseases. This review highlights the relationship between environmental air quality and cardiovascular health, elucidating the pathways through which air pollutants affect the cardiovascular system. It also emphasizes the need for increased awareness, collective efforts to mitigate the adverse effects of air pollution, and strategic policies for long-term air quality improvement to prevent the devastating effects of air pollution on global cardiovascular health.

Systematic review and meta-analysis on the impact of COVID-19 related restrictions on air quality in low- and middle-income countries

BACKGROUND

Low- and middle-income countries (LMIC) are disproportionately affected by air pollution and its health burden, representing a global inequity. The COVID-19 pandemic provided a unique opportunity to investigate the impact of unprecedented lockdown measures on air pollutant concentrations globally. We aim to quantify air pollutant concentration changes across LMIC settings as a result of COVID-19 restrictions.

METHODS

Searches for this systematic review and meta-analysis were carried out across five databases on 30th March 2022; MEDLINE, Embase, Web of Science, Scopus and Transport Research Information Documentation. Modelling and observational studies were included, as long as the estimates reflected city or town level data and were taken exclusively in pre-lockdown and lockdown periods. Mean percentage changes per pollutant were calculated and meta-analyses were carried out to calculate mean difference in measured ground-level observed concentrations for each pollutant (PROSPERO CRD42022326924).

FINDINGS

Of the 2982 manuscripts from initial searches, 256 manuscripts were included providing 3818 percentage changes of all pollutants. No studies included any countries from Sub-Saharan Africa and 34 % and 39.4 % of studies were from China and India, respectively. There was a mean percentage change of -37.4 %, -21.7 %, -54.6 %, -39.1 %, -48.9 %, 16.9 %, -34.9 %, -30.6 % and - 14.7 % for black carbon (BC), carbon monoxide (CO), nitric oxide (NO), nitrogen dioxide (NO2), oxides of nitrogen (NOx), ozone (O3), particulate matter 10 (PM10) and 2.5 (PM2.5) and sulphur dioxide (SO2), respectively. Meta-analysis included 100 manuscripts, providing 908 mean concentration differences, which showed significant reduction in mean concentration in all study settings for BC (-0.46 μg/m3, PI -0.85; -0.08), CO (-0.25 mg/m3, PI -0.44; -0.03), NO2 (-19.41 μg/m3, PI -31.14; -7.68) and NOx (-22.32 μg/m3, PI -40.94; -3.70).

INTERPRETATION

The findings of this systematic review and meta-analysis quantify and confirm the trends reported across the globe in air pollutant concentration, including increases in O3. Despite the majority of global urban growth occurring in LMIC, there are distinct geographical gaps in air pollution data and, where it is available, differing approaches to analysis and reporting.

Tracking air quality trends and vehicle traffic dynamics at urban scale using satellite and ground data before and after the COVID-19 outbreak

The implications of the COVID-19 outbreak are subjected to an increasing number of studies. So far, air quality trends related to the lockdown due to the pandemic have been analysed in large cities or entire regions. In this work, the region studied is the metropolitan area of Cagliari, which is the main city on the island of Sardinia (Italy) and can be representative of a coastal city that includes industrial settlements. The purpose of the study is to evaluate the effect of restrictions related to the COVID-19 outbreak on air quality levels and the traffic dynamics in this type of urban area. Nitrogen Dioxide (NO₂) levels before, during and after COVID-19 lockdown have been investigated using data acquired from the Sentinel-5P/TROPOMI satellite combined with on-site measurements. Both TROPOMI detected and ground-based data have revealed higher levels of NO₂ before and after the lockdown, compared to those during the period of COVID-related restrictions, in particular in the urban area of Cagliari. On the other hand, NO2 registered in the oil refinery area did not show significant differences associated with lockdown. The correlation of TROPOMI NO₂ tropospheric column with ground data (surface NO2) on a monthly mean basis showed different values based on the background and the highest Pearson's coefficient was of about 0.78 near to the city centre, where traffic can be considered a significant source of emission. In addition, a comparison of the air pollution level with the dynamics of vehicle traffic was investigated. The study highlighted a remarkable correlation between the reduction of the number of vehicles and the corresponding tropospheric NO₂ values that decreased on a weekly mean basis.

The Effect of the COVID-19 Pandemic on Environmental Health (Two Sides of the Same Coin): A Systematic Review

BACKGROUND

The outbreak of the COVID-19 pandemic in late 2019 has led to many changes such as reduced human activities and effects on the environment. There is no big picture of the effects of pandemics on the environment using related evidence.

OBJECTIVES

This study was conducted to investigate the effect of the COVID-19 pandemic on environmental health.

METHODS

A systematic search of English language studies was performed in major electronic databases; Web of Science, PubMed, Scopus, and Google scholar web search engine from December 2019 to February 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard guidelines were used to follow up the review process. finally 58 articles entered the review procedure.

RESULTS

The results of indicate a significant reduction of air pollutants and improved air quality. It improved the water quality of some rivers, canals, and seas during the lockdown of the COVID-19 pandemic. The effects of this disease on the environment cannot be fully described yet.

CONCLUSION

In the short term, the amount of air, water, and coastal pollution has been reduced. few studies have examined the effects of pandemics on the environment in the long run, which paves the way for more researches.

Particulate matter air pollution and COVID-19 infection, severity, and mortality: A systematic review and meta-analysis

Ecological evidence links ambient particulate matter ≤2.5 mm (PM_2.5) and the rate of COVID-19 infections, severity, and deaths. However, such studies are unable to account for individual-level differences in major confounders like socioeconomic status and often rely on imprecise measures of PM_2.5. We conducted a systematic review of case-control and cohort studies, which rely on individual-level data, searching Medline, Embase, and the WHO COVID-19 database up to 30 June 2022. Study quality was evaluated using the Newcastle-Ottawa Scale. Results were pooled with a random effects meta-analysis, with Egger's regression, funnel plots, and leave-one-out/trim-and-fill sensitivity analyses to account for publication bias. N = 18 studies met inclusion criteria. A 10 μg/m³ increase in PM_2.5 was associated with 66 % (95 % CI: 1.31-2.11) greater odds of COVID-19 infection (N = 7) and 127 % (95 % CI: 1.41-3.66) odds of severe illness (hospitalisation, ICU admission, or requiring respiratory support) (N = 6). Pooled mortality results (N = 5) indicated increased deaths due to PM_2.5 but were non-significant (OR 1.40; 0.94 to 2.10). Most studies were rated "good" quality (14/18 studies), though there were numerous methodological issues; few used individual-level data to adjust for socioeconomic status (4/18 studies), instead using area-based indicators (11/18 studies) or no such adjustments (3/18 studies). Most severity (9/10 studies) and mortality studies (5/6 studies) were based on people already diagnosed COVID-19, potentially introducing collider bias. There was evidence of publication bias in studies of infection (p = 0.012) but not severity (p = 0.132) or mortality (p = 0.100). While methodological limits and evidence of bias require cautious interpretation of the findings, we found compelling evidence that PM_2.5 increases the risk of COVID-19 infection and severe disease, and weaker evidence of an increase in mortality risk.

Characteristics, sources and health risk assessment of atmospheric carbonyls during multiple ozone pollution episodes in urban Beijing: Insights into control strategies

Carbonyls have attracted continuous attention due to their critical roles in atmospheric chemistry and their potential hazards to the ecological environment and human health. In this study, atmospheric carbonyls were measured during several ground-level-ozone (O₃) pollution episodes at three urban sites (CRAES, IEP and BJUT) in Beijing in 2019 and 2020. Comparative analysis revealed that the carbonyl concentrations were 20.25 ± 6.91 ppb and 13.43 ± 5.13 ppb in 2019 and 2020 in Beijing, respectively, with a significant spatial trend from north to south, and carbonyl levels in urban Beijing were in an upper-intermediate range in China, and higher than those in other countries reported in the literature. A particularly noteworthy phenomenon is the consistency of carbonyl concentrations with variations in O₃ concentrations. On O₃ polluted days, the carbonyl concentrations were 1.3-1.5 times higher than those on non-O₃ polluted days. Secondary formation contributed more to formaldehyde (FA) and acetaldehyde (AA) on O₃ polluted days, while the anthropogenic emissions were more significant for acetone (AC) on non-O₃ polluted days. Vehicle exhaust and solvent utilization were the main primary contributors to carbonyls. Due to reduced anthropogenic emissions caused by the COVID-19 lockdown and the "Program for Controlling Volatile Organic Compounds in 2020" in China, the contributions of primary emissions to carbonyls decreased in 2020 in Beijing. Human cancer risks to exposed populations from FA and AA increased with elevated O₃ levels, and the risks still remained on non-O₃ polluted days. The residents around the BJUT site might experience relatively higher human cancer risks than those around the other two sites. The findings in this study confirmed that atmospheric carbonyl pollution and its potential human health hazards cannot be ignored in urban Beijing; therefore, more strict control strategies for atmospheric carbonyls are urgently needed to better protect human health in Beijing in the future.

Air pollution in Sarajevo, Bosnia and Herzegovina, assessed by plant comet assay

Bosnia and Herzegovina (B&H) is among the European countries with the highest rate of air pollution-related death cases and the poorest air quality. The main causes are solid fuel consumption, traffic, and the poorly developed or implemented air pollution reduction policies. In addition, the city of Sarajevo, the capital of B&H, suffers temperature inversion episodes in autumn/winter months, which sustain air pollution. Human biomonitoring studies may be confounded by the lifestyle of subjects or possible metabolic alterations. Therefore, this study aimed to evaluate Ligustrum vulgare L. as a model for air pollution monitoring by measuring DNA damage at one rural and two urban sites. DNA damage was measured as tail intensity (TI) in L. vulgare leaves, considering seasonal, sampling period, leaf position and staging, and spatial (urban versus rural) variation. Effects of COVID-19 lockdown on TI were assessed by periodical monitoring at one of the selected sites, while in-house grown L. vulgare plants were used to test differences between outdoor and indoor air pollution effects for the same sampling period. Significantly higher TI was generally observed in leaves collected in Campus in December 2020 and 2021 compared with March (P < 0.0001). Outer and adult leaves showed higher TI values, except for the rural site where no differences for these categories were found. Leaves collected in the proximity of the intensive traffic showed significantly higher TI values (P < 0.001), regardless of the sampling period and the stage of growth. In regards to the COVID-19 lockdown, higher TI (P < 0.001) was registered in December 2020, after the lockdown period, than in periods before COVID-19 outbreak or immediately after the lockdown in 2020. This also reflects mild air pollution conditions in summer. TI values for the in-house grown leaves were significantly lower compared to those in situ. Results showed that L. vulgare may present a consistent model for the air pollution biomonitoring but further studies are needed to establish the best association between L. vulgare physiology, air quality data, and air pollution effects.

Lessons learnt for air pollution mitigation policies from the COVID-19 pandemic: The Italian perspective

Policies to improve air quality need to be based on effective plans for reducing anthropogenic emissions. In 2020, the outbreak of COVID-19 pandemic resulted in significant reductions of anthropogenic pollutant emissions, offering an unexpected opportunity to observe their consequences on ambient concentrations. Taking the national lockdown occurred in Italy between March and May 2020 as a case study, this work tries to infer if and what lessons may be learnt concerning the impact of emission reduction policies on air quality. Variations of NO₂, O₃, PM₁₀ and PM_2.5 concentrations were calculated from numerical model simulations obtained with business as usual and lockdown specific emissions. Both simulations were performed at national level with a horizontal resolution of 4 km, and at local level on the capital city Rome at 1 km resolution. Simulated concentrations showed a good agreement with in-situ observations, confirming the modelling systems capability to reproduce the effects of emission reductions on ambient concentration variations, which differ according to the individual air pollutant. We found a general reduction of pollutant concentrations except for ozone, that experienced an increase in Rome and in the other urban areas, and a decrease elsewhere. The obtained results suggest that acting on precursor emissions, even with sharp reductions like those experienced during the lockdown, may lead to significant, albeit complex, reduction patterns for secondary pollutant concentrations. Therefore, to be more effective, reduction measures should be carefully selected, involving more sectors than those related to mobility, such as residential and agriculture, and integrated on different scales.

Choosing multiple linear regressions for weather-based crop yield prediction with ABSOLUT v1.2 applied to the districts of Germany

ABSOLUT v1.2 is an adaptive algorithm that uses correlations between time-aggregated weather variables and crop yields for yield prediction. In contrast to conventional regression-based yield prediction methods, a very broad range of possible input features and their combinations are exhaustively tested for maximum explanatory power. Weather variables such as temperature, precipitation, and sunshine duration are aggregated over different seasonal time periods preceding the harvest to 45 potential input features per original variable. In a first step, this large set of features is reduced to those aggregates very probably holding explanatory power for observed yields. The second, computationally demanding step evaluates predictions for all districts with all of their possible combinations. Step three selects those combinations of weather features that showed the highest predictive power across districts. Finally, the district-specific best performing regressions among these are used for actual prediction, and the results are spatially aggregated. To evaluate the new approach, ABSOLUT v1.2 is applied to predict the yields of silage maize, winter wheat, and other major crops in Germany based on two decades of data from about 300 districts. It turned out to be absolutely crucial to not only make out-of-sample predictions (solely based on data excluding the target year to predict) but to also consequently separate training and testing years in the process of feature selection. Otherwise, the prediction accuracy would be over-estimated by far. The question arises whether performances claimed for other statistical modelling examples are often upward-biased through input variable selection disregarding the out-of-sample principle.

An overview and thematic analysis of research on cities and the COVID-19 pandemic: Toward just, resilient, and sustainable urban planning and design

Since early 2020, researchers have made efforts to study various issues related to cities and the pandemic. Despite the wealth of research on this topic, there are only a few review articles that explore multiple issues related to it. This is partly because of the rapid pace of publications that makes systematic literature review challenging. To address this issue, in the present study, we rely on bibliometric analysis techniques to gain an overview of the knowledge structure and map key themes and trends of research on cities and the pandemic. Results of the analysis of 2,799 articles show that research mainly focuses on six broad themes: air quality, meteorological factors, built environment factors, transportation, socio-economic disparities, and smart cities, with the first three being dominant. Based on the findings, we discuss major lessons that can be learned from the pandemic and highlight key areas that need further research.

Changes in Ultrafine Particle Concentrations near a Major Airport Following Reduced Transportation Activity during the COVID-19 Pandemic

Mobility reductions following the COVID-19 pandemic in the United States were higher, and sustained longer, for aviation than ground transportation activity. We evaluate changes in ultrafine particle (UFP, Dp < 100 nm, a marker of fuel-combustion emissions) concentrations at a site near Logan Airport (Boston, Massachusetts) in relation to mobility reductions. Several years of particle number concentration (PNC) data prepandemic [1/2017-9/2018] and during the state-of-emergency (SOE) phase of the pandemic [4/2020-6/2021] were analyzed to assess the emissions reduction impact on PNC, controlling for season and wind direction. Mean PNC was 48% lower during the first three months of the SOE than prepandemic, consistent with 74% lower flight activity and 39% (local)-51% (highway) lower traffic volume. Traffic volume and mean PNC for all wind directions returned to prepandemic levels by 6/2021; however, when the site was downwind from Logan Airport, PNC remained lower than prepandemic levels (by 23%), consistent with lower-than-normal flight activity (44% below prepandemic levels). Our study shows the effect of pandemic-related mobility changes on PNC in a near-airport community, and it distinguishes aviation-related and ground transportation source contributions.

Impact of COVID-19 restrictions on the dry deposition fraction of settleable particulate matter at three industrial urban/suburban locations in northern Spain

Ninety 24-h samples of the dry deposition fraction of settleable particulate matter (DSPM) were collected at one suburban industrial site ('EMA') and two urban industrial sites ('Lauredal' and 'Laboratory') in the western area of Gijón (North of Spain) from December 2019 to June 2020. The levels registered point to an environmental issue that should receive close attention from environmental authorities. Before lockdown restrictions due to COVID-19 were established, all samples collected at the EMA site exceeded 300 mg·m^-2·d^-1 (the Spanish limit value until 2002). Large amounts of DSPM were also registered at the Lauredal and Laboratory sites, maximum levels reaching 1039.2 and 672.7 mg·m^-2·d^-1, respectively. Seven metals were analysed in DSPM samples: Al, Ca, Fe, K, Mg, Mn and Na. Fe reached the highest values: 2473.4, 463.4 and 293.3 mg·m^-2·d^-1 (EMA, Lauredal and Laboratory sites, respectively). This study quantifies the reductions in the DSPM levels registered (on average, 97.2, 73.5 and 90.5% at the EMA, Lauredal and Laboratory sites, respectively) during the lockdown, which involved the restriction of population mobility and industrial activity. The influence of wind speed and its direction were also assessed to better understand the role of these restrictions in the observed reductions. The concentrations of all the metals in the DSPM were reduced by more than 75%, on average, except for K at the Laboratory and Lauredal sites. These decreases were much higher than those found by other authors for smaller fractions of the atmospheric particulate matter (PM10, PM2.5). The findings of the present study highlight the importance of DSPM in highly industrialized urban/suburban locations and indicate the direction that legal measures might take, given the influence of anthropogenic emissions.

Evaluation of Istanbul from the environmental components' perspective: what has changed during the pandemic?

This study aims to determine the 1-year change over the pandemic period in Istanbul, the megacity with the highest population in Turkey, based on environmental components. Among the environmental topics, water consumption habits, changes in air quality, changes due to noise elements, and most importantly, the changes in usage habits of disposable plastic materials that directly affect health have been revealed. The results obtained showed that, in Istanbul, 8.1 × 10⁸ gloves should be considered waste, and considering the population living in districts along coastal areas, the number of waste masks that are likely to end up in the sea was 325.648 pieces/day. The results of the air quality and noise measurements during the pandemic showed that reductions in parallel with human activities were recorded with the lockdown effect. The average noise values of the districts along both sides of the Bosporus, where urbanization is concentrated, were between 50 and 59 dB. The precautions taken during the pandemic have had an effective role in reducing air pollution in Istanbul. In the measurements, the parameters with effective reductions were PM₁₀ (7-47%), PM_2.5 (13-48%), NO₂ (13-38%), and SO₂ (10-56%). As a result, Istanbul's year of changes during the pandemic period, in terms of water, air, noise, and solid plastic wastes, which are the most important components of the environment, is presented.

An Epidemiological Study to Investigate Links between Atmospheric Pollution from Farming and SARS-CoV-2 Mortality

Exposure to atmospheric particulate matter and nitrogen dioxide has been linked to SARS-CoV-2 infection and death. We hypothesized that long-term exposure to farming-related air pollutants might predispose to an increased risk of COVID-19-related death. To test this hypothesis, we performed an ecological study of five Italian Regions (Piedmont, Lombardy, Veneto, Emilia-Romagna and Sicily), linking all-cause mortality by province (administrative entities within regions) to data on atmospheric concentrations of particulate matter (PM_2.5 and PM₁₀) and ammonia (NH₃), which are mainly produced by agricultural activities. The study outcome was change in all-cause mortality during March-April 2020 compared with March-April 2015-2019 (period). We estimated all-cause mortality rate ratios (MRRs) by multivariate negative binomial regression models adjusting for air temperature, humidity, international import-export, gross domestic product and population density. We documented a 6.9% excess in MRR (proxy for COVID-19 mortality) for each tonne/km² increase in NH₃ emissions, explained by the interaction of the period variable with NH₃ exposure, considering all pollutants together. Despite the limitations of the ecological design of the study, following the precautionary principle, we recommend the implementation of public health measures to limit environmental NH₃ exposure, particularly while the COVID-19 pandemic continues. Future studies are needed to investigate any causal link between COVID-19 and farming-related pollution.

Impact of COVID-19 on Hospital Admissions and Healthcare Quality Indicators in Non-COVID Patients: A Retrospective Study of the First COVID-19 Year in a University Hospital in Spain

Few studies have assessed the impact of the COVID-19 pandemic on non-COVID diseases and healthcare quality. We aimed to evaluate changes in rates of hospitalisations, complications, in-hospital mortality, and readmissions among patients with non-COVID diseases during a one-year period after the pandemic onset. From March 2018 to February 2021 a retrospective observational study of hospital admissions in a university hospital in Spain was conducted. Non-COVID hospitalisations admitted through the emergency department were compared between the pre-COVID period (n = 28,622) and the COVID period (n = 11,904). We assessed rate ratios (RaR), comparing the weekly number of admissions and risk ratios (RR) to examine rates of complications, in-hospital mortality, readmissions, and severity. Statistical significance was set at p < 0.05. The weekly admission rate dropped by 20.8% during the complete lockdown. We observed significant reductions in admissions related to diseases of the respiratory system and circulatory system. Admissions for endocrine and metabolic diseases increased. The complication rates increased (RR = 1.21, 95% CI: 1.05;1.4), while in-hospital mortality rates held steady during the COVID period (RR = 1.09, 95% CI: 0.98;1.2). Hospital efforts to maintain quality and safety standards despite disruptions translated into a moderate increase in complications but not in in-hospital mortality. Reduced hospitalisations for conditions requiring timely treatment may have significant public health consequences.