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However, the specific links between air pollution and severe acute respiratory syndrome-coronavirus-2 infection remain unclear. Here we provide evidence from\n                    <jats:italic>in vitro<\/jats:italic>\n                    , animal and human studies from the existing literature. Epidemiological investigations have related various air pollutants to COVID-19 morbidity and mortality at the population level, however, those studies suffer from several limitations. Air pollution may be linked to an increase in COVID-19 severity and lethality through its impact on chronic diseases, such as cardiopulmonary diseases and diabetes. Experimental studies have shown that exposure to air pollution leads to a decreased immune response, thus facilitating viral penetration and replication. Viruses may persist in air through complex interactions with particles and gases depending on: 1) chemical composition; 2) electric charges of particles; and 3) meteorological conditions such as relative humidity, ultraviolet (UV) radiation and temperature. In addition, by reducing UV radiation, air pollutants may promote viral persistence in air and reduce vitamin D synthesis. Further epidemiological studies are needed to better estimate the impact of air pollution on COVID-19.\n                    <jats:italic>In vitro<\/jats:italic>\n                    and\n                    <jats:italic>in vivo<\/jats:italic>\n                    studies are also strongly needed, in particular to more precisely explore the particle\u2013virus interaction in air.\n                  <\/jats:p>","DOI":"10.1183\/16000617.0242-2020","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T03:49:31Z","timestamp":1612928971000},"page":"200242","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":205,"title":["The impact of outdoor air pollution on COVID-19: a review of evidence from\n                    <i>in vitro<\/i>\n                    , animal, and human studies"],"prefix":"10.1183","volume":"30","author":[{"given":"Thomas","family":"Bourdrel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Annesi-Maesano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barrak","family":"Alahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara N.","family":"Maesano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Ab\u00e8le","family":"Bind","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2021,2,9]]},"reference":[{"key":"2024102403520991000_30.159.200242.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2001017"},{"key":"2024102403520991000_30.159.200242.2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00547-2020"},{"key":"2024102403520991000_30.159.200242.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2020.102537"},{"key":"2024102403520991000_30.159.200242.4","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.acvd.2017.05.003","article-title":"Cardiovascular effects of air pollution","volume":"110","author":"Bourdrel","year":"2017","journal-title":"Arch Cardiovasc Dis"},{"key":"2024102403520991000_30.159.200242.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.10.042"},{"key":"2024102403520991000_30.159.200242.6","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000847"},{"key":"2024102403520991000_30.159.200242.7","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-009493"},{"key":"2024102403520991000_30.159.200242.8","unstructured":"STROBE Statement . 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