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The coronavirus is dangerous. But some experts wonder if bad air makes it worse.

With thousands of deaths already in the raging coronavirus pandemic, it’s clear the disease is worse for the elderly and those with preexisting health problems. But scientists are considering whether more subtle factors may also intensify the disease or increase the initial chances of infection -- including smoking and air pollution.

There are no large scale studies from the current outbreak of coronavirus, which causes a disease known as covid-19, that directly support this conclusion -- and only a few hints from smaller studies.

But experts note that damage to the lungs from pollutants that result from combustion -- whether inhaled deliberately by smokers, or inadvertently by those in regions with poor air quality -- may increase the risk of respiratory tract infections from viruses such as the novel coronavirus. Poor air can also cause lung inflammation that could worsen the symptoms of covid-19.

“Given what we know now, it is very likely that people who are exposed to more air pollution and who are smoking tobacco products are going to fare worse if infected with covid than those who are breathing cleaner air, and who don’t smoke,” said Aaron Bernstein, the interim director of the Center for Climate, Health, and the Global Environment at the Harvard T.H. Chan School of Public Health.

Not everyone is convinced at this point of a linkage.

“I would still treat this as a hypothesis – a reasonable one, but still a hypothesis,” said Anna Hansell, an expert in environmental epidemiology at the University of Leicester in the United Kingdom.

The evidence for this hypothesis comes from two sources. First, there are a number of admittedly imperfect studies conducted during outbreaks caused by the evolutionary cousins of the current coronavirus. And second, there’s more basic medical reasoning about how coronavirus and the products of combustion -- a noxious mix of chemicals and gases -- affect the lungs.

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