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Higher mortality was also correlated with relatively poor air quality. When summarizing the results at a greater administrative level, we found that the 10 provinces (U.S. state equivalent) with the highest rate of mortality by COVID-19, were often the most polluted but not the most densely populated. Air pollution appears to be a risk factor for the incidence of this disease, despite the conventionally apprehended influence of human mobility on disease dynamics from the site of first appearance, Wuhan. The raw correlations reported here should be interpreted in a broader context, accounting for the growing evidence reported by several other studies. These findings warn communities and policymakers on the implications of long-term air pollution exposure as an ecological, multi-scale public health issue.<\/jats:p>","DOI":"10.3389\/fpubh.2020.597753","type":"journal-article","created":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T01:02:27Z","timestamp":1611277347000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":31,"title":["COVID-19 Higher Mortality in Chinese Regions With Chronic Exposure to Lower Air Quality"],"prefix":"10.3389","volume":"8","author":[{"given":"Riccardo","family":"Pansini","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Fornacca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,1,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1403","DOI":"10.1007\/s11869-020-00894-8","article-title":"A brief review of socio-economic and environmental impact of Covid-19","volume":"13","author":"Bashir","year":"2020","journal-title":"Air Qual Atmos Health."},{"key":"B2","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1016\/S0140-6736(20)30185-9","article-title":"A novel coronavirus outbreak of global health concern","volume":"395","author":"Wang","year":"2020","journal-title":"Lancet."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e750","DOI":"10.1016\/S2214-109X(20)30225-4","article-title":"Health system reform in China: the challenges of multimorbidity","volume":"8","author":"Zhai","year":"2020","journal-title":"Lancet Global Health."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study","volume":"395","author":"Zhou","year":"2020","journal-title":"Lancet."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e105114","DOI":"10.15252\/embj.2020105114","article-title":"SARS-CoV-2 receptor ACE2 and TMPRSS2 are primarily expressed in bronchial transient secretory cells","volume":"39","author":"Lukassen","year":"2020","journal-title":"EMBO J."},{"key":"B6","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1038\/s41586-019-1717-y","article-title":"A new twenty-first century science for effective epidemic response","volume":"575","author":"Bedford","year":"2019","journal-title":"Nature."},{"key":"B7","doi-asserted-by":"publisher","first-page":"109814","DOI":"10.1016\/j.envres.2020.109814","article-title":"Understanding COVID-19 diffusion requires an interdisciplinary, multi-dimensional approach","volume":"188","author":"Bontempi","year":"2020","journal-title":"Environ Res."},{"key":"B8","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1038\/nature15371","article-title":"The contribution of outdoor air pollution sources to premature mortality on a global scale","volume":"525","author":"Lelieveld","year":"2015","journal-title":"Nature."},{"key":"B9","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1056\/NEJMe0809178","article-title":"Evaluating the effects of ambient air pollution on life expectancy","volume":"360","author":"Krewski","year":"2009","journal-title":"N Engl J Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"4487","DOI":"10.3390\/ijerph17124487","article-title":"Air pollution and Covid-19: the role of particulate matter in the spread and increase of Covid-19's morbidity and mortality","volume":"17","author":"Comunian","year":"2020","journal-title":"Int J Environ Res Public Health."},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1101\/2020.05.28.20115832","article-title":"COVID-19 higher morbidity and mortality in Chinese regions with lower air quality","author":"Pansini","year":"2020","journal-title":"medRxiv"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10668-020-00878-9","article-title":"Air pollution aggravating COVID-19 lethality? 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