Purpose of Review Several environmental contaminants have been implicated as contributors to COVID-19 susceptibility and severity. Immunomodulation and epigenetic regulation have been hypothesized as mediators of this relationship, but the precise underlying molecular mechanisms are not well-characterized. This review examines the evidence for epigenetic modification at the intersection of COVID-19 and environmental chemical exposures. Recent Findings Numerous environmental contaminants including air pollutants, toxic metal(loid)s, per- and polyfluorinated substances, and endocrine disrupting chemicals are hypothesized to increase susceptibility to the SARS-CoV-2 virus and the risk of severe COVID-19, but few studies currently exist. Drawing on evidence that many environmental chemicals alter the epigenetic regulation of key immunity genes and pathways, we discuss how exposures likely perturb host antiviral responses. Specific mechanisms vary by contaminant but include general immunomodulation as well as regulation of viral entry and recognition, inflammation, and immunologic memory pathways, among others. Summary Associations between environmental contaminants and COVID-19 are likely mediated, in part, by epigenetic regulation of key immune pathways involved in the host response to SARS-CoV-2.

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Toxic metal exposure via private drinking wells is an environmental health challenge in North Carolina (NC). Policies tainted by environmental racism shape who has access to public water supplies, with Black People, Indigenous People, and People of Color (BIPOC) often excluded from municipal services. Thus, toxic metal exposure via private wells is an environmental justice (EJ) issue, and it is under-studied in NC. In this study, we developed four Toxic Metal Environmental Justice Indices (TM-EJIs) for inorganic arsenic (iAs), cadmium (Cd), lead (Pb), and manganese (Mn) to quantitatively identify areas of environmental injustice in NC. TM-EJIs were calculated at the census tract level (n = 2038) as the product of the following: (1) number of well water tests with concentrations exceeding national standards, (2) percentage of the low-income and minority population, and (3) population density. Mn had the greatest proportion (25.17%) of positive TM-EJIs, which are indicative of socioeconomically disadvantaged groups exposed to toxic metals. Positive TM-EJIs, particularly for Pb and Mn, were primarily located in eastern NC. These results highlight several new counties of concern and can be used by public health professionals and state environmental agencies to prioritize remediation efforts and efforts to reduce environmental injustices.

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