India enforced stringent lockdown measures on March 24, 2020 to mitigate the spread of the Severe Acute Respiratory Syndrome Coronovirus-2 (SARS-CoV-2). Here, we examined the impact of lockdown on the air quality index (AQI) [including ambient particulate matter (PM 10 and PM 2.5 ), nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), carbon monoxide (CO), ozone (O 3 ), and ammonia (NH 3 )] and tropospheric NO 2 and O 3 densities through Sentinel-5 satellite data approximately 1 d post-lockdown and one month pre-lockdown and post-lockdown. Our findings revealed a marked reduction in the ambient AQI (estimated mean reduction of 17.75% and 20.70%, respectively), tropospheric NO 2 density, and land surface temperature (LST) during post-lockdown compared with the pre-lockdown period or corresponding months in 2019, except for a few sites with substantial coal mining and active power plants. We observed a modest increase in the O 3 density post-lockdown, thereby indicating improved tropospheric air quality. As a favorable outcome of the COVID-19 lockdown, road accident-related mortalities declined by 72-folds. Cities with poor air quality correlate with higher COVID-19 cases and deaths ( r =0.504 and r =0.590 for NO 2 ; r =0.744 and r =0.435 for AQI). Conversely, low mortality was reported in cities with better air quality. These results show a correlation between the COVID-19 vulnerable regions and AQI hotspots, thereby suggesting that air pollution may exacerbate clinical manifestations of the disease. However, a prolonged lockdown may nullify the beneficial environmental outcomes by adversely affecting socioeconomic and health aspects.

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Background and Purpose: Acute ischemic stroke may occur in patients with Coronavirus disease 2019 but risk factors, in hospital events, and outcomes are not well studied in large cohorts. We identified risk factors, co-morbidities, and outcomes in patients with Coronavirus disease 2019 with or without acute ischemic stroke and compared with patients without Coronavirus disease 2019 and acute ischemic stroke. Methods: We analyzed the data from 54 healthcare facilities using the Cerner de-identified Coronavirus disease 2019 dataset. The dataset included patients with an emergency department or inpatient encounter with a discharge diagnoses codes that could be associated to suspicion of or exposure to Coronavirus disease 2019, or confirmed Coronavirus disease 2019. Results: A total of 103 (1.3%) patients developed acute ischemic stroke among 8,163 patients with Coronavirus disease 2019. Among all Coronavirus disease 2019 patients, the proportion of patients with hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation and congestive heart failure was significantly higher among those with acute ischemic stroke. Acute ischemic stroke was associated with discharge to destination other than home or death (relative risk 2.1, 95% confidence interval 1.7-2.4, p<.0001) after adjusting for potential confounders. A total of 199 (1.0%) patients developed acute ischemic stroke among 19,513 patents without Coronavirus disease 2019. Among all ischemic stroke patients, Coronavirus disease 2019 was associated with discharge to destination other than home or death (relative risk 1.2, 95% confidence interval 1.0-1.3, p=.03) after adjusting for potential confounders. Conclusions: Acute ischemic stroke was infrequent in patients with Coronavirus disease 2019 and usually occurs in presence of other cardiovascular risk factors. The risk of discharge to destination other than home or death increased two folds with occurrence of acute ischemic stroke in patients with Coronavirus disease 2019.

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