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According to initial reports, the lungs were thought to be the primary target, but recent case studies have shown its reach can extend to other organs including the heart and blood vessels. The severity of cardiac complications of COVID-19 depends on multiple underlying factors, with air pollutant exposure being one of them, as reported by several recent studies. Airborne particulate matter (PM) attracts heightened attention due to its implication in various diseases, especially respiratory and cardiovascular diseases. Inhaled PM not only carries microorganisms inside the body but also elicits local and systemic inflammatory responses resulting in altering the host\u2019s immunity and increasing susceptibility to infection. Previous and recent studies have documented that PM acts as a \u2018carrier\u2019 for the virus and aids in spreading viral infections. This review presents the mechanisms and effects of viral entry and how pollution can potentially modulate pathophysiological processes in the heart. We aimed to concisely summarize studies examining cardiovascular outcomes in COVID-19 patients and postulate on how PM can influence these outcomes. We have also reviewed evidence on the use of renin\u2013angiotensin system inhibitors, namely angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, in patients with COVID-19. The interplay of pollution and SARS-CoV-2 is essential to understanding the effects of accentuated cardiovascular effects of COVID-19 and deserves in-depth experimental investigations.<\/jats:p>","DOI":"10.1093\/cvr\/cvaa293","type":"journal-article","created":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T19:14:42Z","timestamp":1601925282000},"page":"85-95","source":"Crossref","is-referenced-by-count":19,"title":["Double trouble: combined cardiovascular effects of particulate matter exposure and coronavirus disease 2019"],"prefix":"10.1093","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8507-2710","authenticated-orcid":false,"given":"Vineeta","family":"Tanwar","sequence":"first","affiliation":[{"name":"Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, 473 W. 12th Avenue, Columbus, OH 43210, USA"},{"name":"College of Nursing, The Ohio State University, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7083-8982","authenticated-orcid":false,"given":"Jeremy M","family":"Adelstein","sequence":"additional","affiliation":[{"name":"Medical Student Research Program, The Ohio State University College of Medicine, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8155-0204","authenticated-orcid":false,"given":"Loren E","family":"Wold","sequence":"additional","affiliation":[{"name":"Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, 473 W. 12th Avenue, Columbus, OH 43210, USA"},{"name":"College of Nursing, The Ohio State University, Columbus, OH, USA"},{"name":"Department of Physiology and Cell Biology, The Ohio State University College of Medicine, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,10,21]]},"reference":[{"key":"2021011509550216300_cvaa293-B1","year":""},{"key":"2021011509550216300_cvaa293-B2","year":""},{"key":"2021011509550216300_cvaa293-B3","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, 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