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Abstract
Epidemiological studies have yielded conflicting results regarding climate and incident SARS-CoV-2 infection, and seasonality of infection rates is debated. Moreover, few studies have focused on COVD-19 deaths. We studied the association of average ambient temperature with subsequent COVID-19 mortality in the OECD countries and the individual United States (US), while accounting for other important meteorological and non-meteorological co-variates. The exposure of interest was average temperature and other weather conditions, measured at 25 days prior and 25 days after the first reported COVID-19 death was collected in the OECD countries and US states. The outcome of interest was cumulative COVID-19 mortality, assessed for each region at 25, 30, 35, and 40 days after the first reported death. Analyses were performed with negative binomial regression and adjusted for other weather conditions, particulate matter, sociodemographic factors, smoking, obesity, ICU beds, and social distancing. A 1 °C increase in ambient temperature was associated with 6% lower COVID-19 mortality at 30 days following the first reported death (multivariate-adjusted mortality rate ratio: 0.94, 95% CI 0.90, 0.99, p = 0.016). The results were robust for COVID-19 mortality at 25, 35 and 40 days after the first death, as well as other sensitivity analyses. The results provide consistent evidence across various models of an inverse association between higher average temperatures and subsequent COVID-19 mortality rates after accounting for other meteorological variables and predictors of SARS-CoV-2 infection or death. This suggests potentially decreased viral transmission in warmer regions and during the summer season.
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1 Cyprus University of Technology, Cyprus International Institute for Environmental and Public Health, Lemesos, Cyprus (GRID:grid.15810.3d) (ISNI:0000 0000 9995 3899); Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X)
2 Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X); Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Department of Preventive Medicine and Public Health, School of Medicine, Madrid, Spain (GRID:grid.38142.3c)
3 Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X); National Cheng Kung University, Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, Tainan, Taiwan (GRID:grid.64523.36) (ISNI:0000 0004 0532 3255)
4 Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Department of Preventive Medicine and Public Health, School of Medicine, Madrid, Spain (GRID:grid.64523.36)
5 National and Kapodistrian University of Athens, Department of Medicine, Athens, Greece (GRID:grid.5216.0) (ISNI:0000 0001 2155 0800)
6 Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X)
7 Cyprus University of Technology, Cyprus International Institute for Environmental and Public Health, Lemesos, Cyprus (GRID:grid.15810.3d) (ISNI:0000 0000 9995 3899)
8 Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X)
9 National and Kapodistrian University of Athens, Laikon General Hospital, First Department of Surgery, Athens, Greece (GRID:grid.5216.0) (ISNI:0000 0001 2155 0800)
10 Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Department of Preventive Medicine and Public Health, School of Medicine, Madrid, Spain (GRID:grid.38142.3c); CEI UAM+CSIC, IMDEA-Food Institute, Madrid, Spain (GRID:grid.482878.9) (ISNI:0000 0004 0500 5302)
11 Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X); Harvard Medical School, Department of Occupational Medicine, Cambridge Health Alliance, Cambridge, USA (GRID:grid.38142.3c) (ISNI:000000041936754X)