{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T19:29:13Z","timestamp":1770319753582,"version":"3.49.0"},"reference-count":61,"publisher":"Korean Society for Preventive Medicine","issue":"1","license":[{"start":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:00:00Z","timestamp":1768608000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["jpmph.org"],"crossmark-restriction":true},"short-container-title":["JPMPH"],"published-print":{"date-parts":[[2026,1,31]]},"abstract":"<jats:p>Objectives: Low-income and middle-income countries in Asia bear a disproportionate burden of particulate matter with an aerodynamic diameter of 2.5 micrometers or less (PM2.5) pollution, yet data remain scarce. This systematic review and meta-analysis aimed to quantify the association between PM2.5 exposure and the risks of coronavirus disease 2019 (COVID-19) infection and mortality in this vulnerable region.Methods: A systematic search was conducted in PubMed, Scopus, and other major databases for studies published up to December 31, 2024. We included observational studies reporting associations between PM2.5 and COVID-19 outcomes in low-income and middle-income Asian countries. Pooled effect sizes and 95% confidence intervals (CIs) were calculated using a random-effects model. The study was registered with PROSPERO (CRD42022316008).Results: Fourteen studies met the inclusion criteria. Separate analyses demonstrated statistically significant positive associations between PM2.5 exposure and COVID-19 infection for both short-term exposure (pooled risk ratio [RR], 1.12; 95% CI, 1.07 to 1.18) and long-term exposure (pooled RR, 1.41; 95% CI, 1.28 to 1.56). For mortality, the analysis identified a statistically non-significant positive association with short-term exposure (pooled RR, 1.37; 95% CI, 0.80 to 2.33). Substantial heterogeneity was observed across all analyses (I\u00b2&gt;75%); however, sensitivity analyses confirmed that the findings for infection were robust.Conclusions: Our findings provide robust evidence that PM2.5 exposure is a significant risk factor for COVID-19 infection in low-income and middle-income Asian countries. The available evidence was insufficient to establish a clear association with mortality. These results underscore the urgent need for strengthened air quality control policies as a critical component of public health strategies to mitigate the burden of respiratory pandemics.<\/jats:p>","DOI":"10.3961\/jpmph.25.499","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T23:52:05Z","timestamp":1769730725000},"page":"12-24","update-policy":"https:\/\/doi.org\/10.3961\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Particulate Matter (PM2.5) With COVID-19 Infection and Mortality in Low-and Middle-income Asian Countries: A Systematic Review and Meta-analysis"],"prefix":"10.3961","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3008-4049","authenticated-orcid":true,"given":"Frisca","family":"Rahmadina","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9340-3922","authenticated-orcid":true,"given":"Riris Andono","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0968-988X","authenticated-orcid":true,"given":"Aditya Lia","family":"Ramadona","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2350","reference":[{"key":"ref1","volume-title":"WHO Director-General\u2019s opening remarks at the media briefing on COVID-19-11 March 2020 [cited 2025 Apr 30]"},{"key":"ref2","volume-title":"WHO COVID-19 dashboard; 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