A global analysis on the effect of temperature, socio-economic and environmental factors on the spread and mortality rate of the COVID-19 pandemic.

We performed a global analysis with data from 149 countries to test whether temperature can explain the spatial variability of the spread rate and mortality of COVID-19 at the global scale. We performed partial correlation analysis and linear mixed effect modelling to evaluate the association of the spread rate and motility of COVID-19 with maximum, minimum, average temperatures and diurnal temperature variation (difference between daytime maximum and night-time minimum temperature) and other environmental and socio-economic parameters. After controlling the effect of the duration since the first positive case, partial correlation analysis revealed that temperature was not related with the spatial variability of the spread rate of COVID-19 at the global scale. Mortality was negatively related with temperature in the countries with high-income economies. In contrast, diurnal temperature variation was significantly and positively correlated with mortality in the low- and middle-income countries. Taking the country heterogeneity into account, mixed effect modelling revealed that inclusion of temperature as a fixed factor in the model significantly improved model skill predicting mortality in the low- and middle-income countries. Our analysis suggests that warm climate may reduce the mortality rate in high-income economies, but in low- and middle-income countries, high diurnal temperature variation may increase the mortality risk.