Effects of Environmental Factors on Severity and Mortality of COVID-19

• Main Authors: Domagoj Kifer, Dario Bugada, Judit Villar-Garcia, Ivan Gudelj, Cristina Menni, Carole Sudre, Frano Vučković, Ivo Ugrina, Luca F. Lorini, Margarita Posso, Silvia Bettinelli, Nicola Ughi, Alessandro Maloberti, Oscar Epis, Cristina Giannattasio, Claudio Rossetti, Livije Kalogjera, Jasminka Peršec, Luke Ollivere, Benjamin J. Ollivere, Huadong Yan, Ting Cai, Guruprasad P. Aithal, Claire J. Steves, Anu Kantele, Mikael Kajova, Olli Vapalahti, Antti Sajantila, Rafal Wojtowicz, Waldemar Wierzba, Zbigniew Krol, Artur Zaczynski, Katarina Zycinska, Marek Postula, Ivica Lukšić, Rok Čivljak, Alemka Markotić, Johannes Brachmann, Andreas Markl, Christian Mahnkopf, Benjamin Murray, Sebastien Ourselin, Ana M. Valdes, Juan P. Horcajada, Xavier Castells, Julio Pascual, Massimo Allegri, Dragan Primorac, Tim D. Spector, Clara Barrios, Gordan Lauc
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2021-01-01
• Series: Frontiers in Medicine
• Subjects: COVID-19; seasonality; mortality; mucins; humidity
• Online Access: https://www.frontiersin.org/articles/10.3389/fmed.2020.607786/full
• ISSN: 2296-858X

Background: Most respiratory viruses show pronounced seasonality, but for SARS-CoV-2, this still needs to be documented.Methods: We examined the disease progression of COVID-19 in 6,914 patients admitted to hospitals in Europe and China. In addition, we evaluated progress of disease symptoms in 37,187 individuals reporting symptoms into the COVID Symptom Study application.Findings: Meta-analysis of the mortality risk in seven European hospitals estimated odds ratios per 1-day increase in the admission date to be 0.981 (0.973–0.988, p < 0.001) and per increase in ambient temperature of 1°C to be 0.854 (0.773–0.944, p = 0.007). Statistically significant decreases of comparable magnitude in median hospital stay, probability of transfer to the intensive care unit, and need for mechanical ventilation were also observed in most, but not all hospitals. The analysis of individually reported symptoms of 37,187 individuals in the UK also showed the decrease in symptom duration and disease severity with time.Interpretation: Severity of COVID-19 in Europe decreased significantly between March and May and the seasonality of COVID-19 is the most likely explanation.