If you've been exposed to air pollution for a long time, you're more likely to get Covid-19.
The study found that people who lived in places with high levels of nitrogen dioxide were more likely to end up in an intensive care unit.
When fossil fuels are burned, nitrogen dioxide is released into the atmosphere, which can be harmful to the lungs. The transfer of oxygen from exhaled breath to a person's blood can be affected by the damage to the heart and blood vessels.
The results show a positive association between long-term nitrogen dioxide exposure and Covid-19 fatality and Covid-19 incidence rate.
Few studies have focused on cases that were particularly severe or on underlying health conditions in those affected by Covid.
Koch and her team used air pollution data to calculate nitrogen dioxide levels. The group presented its findings to the European Society of Anaesthesiology and Intensive Care in Milan last week.
The group studied the number of Covid patients in German hospitals who had to be treated in the intensive care unit. The figures were adjusted to account for other factors.
In each of the 10 counties that had the lowest long-term nitrogen dioxide exposure, the team found that Covid patients needed an average of 28 intensive care beds and 19 ventilators. In the 10 counties with the highest long-term exposure, the average number of intensive care beds and ventilators needed was 142.
It has worrying implications. In the UK, 75% of urban areas had illegal levels of air pollution in 2019. There was a drop in nitrogen in some areas. Many towns and cities are seeing traffic and pollution return to previous levels.
According to the Royal College of Physicians, air pollution causes the equivalent of 40,000 deaths a year and has been linked to cancer, asthma, stroke and heart disease. Evidence is mounting that Covid should be added.
The German study did not show a correlation between air pollution and Covid. They suggested a link between the levels of nitrogen dioxide in the atmosphere and the severity of Covid.
When coronaviruses enter cells, they bind to the Ace-2receptor. One of the key roles of this receptor is to help the body regulate levels of angiotensin II. The brakes on inflammation are put on by ace-2
The brakes are removed when Covid binding to ace-2 Air pollution can cause the release of controls over angiotensin II. The team argued that the combination of Covid and long-term air pollution exposure would cause more severe inflammation, more severe Covid and more need for intensive care units.
Koch said that exposure to air pollution can cause a range of other conditions, including heart attacks, strokes, asthma and lung cancer. There is a need for a transition to renewable energy, clean transportation and sustainable agriculture. The health and quality of life of people around the world will be improved if emissions are reduced.