COVID-19 Higher Mortality in Chinese Regions With Chronic Exposure to Lower Air Quality

Abstract
We investigated the geographical character of the COVID-19 infection in China and correlated it with satellite- and ground-based measurements of air quality. Controlling for population density, we found more viral infections in those prefectures (U.S. county equivalent) afflicted by high Carbon Monoxide, Formaldehyde, PM 2.5, and Nitrogen Dioxide values. 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.