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. 2021 Jan 11;21(1):117.
doi: 10.1186/s12889-020-10131-7.

The association between ambient temperature and mortality of the coronavirus disease 2019 (COVID-19) in Wuhan, China: a time-series analysis

Gaopei Zhu  1 , Yuhang Zhu  1   2 , Zhongli Wang  3 , Weijing Meng  4 , Xiaoxuan Wang  1 , Jianing Feng  1 , Juan Li  1 , Yufei Xiao  1 , Fuyan Shi  5 , Suzhen Wang  6
Affiliations

The association between ambient temperature and mortality of the coronavirus disease 2019 (COVID-19) in Wuhan, China: a time-series analysis

Gaopei Zhu et al. BMC Public Health. .

Abstract

Background: The COVID-19 has caused a sizeable global outbreak and has been declared as a public health emergency of international concern. Sufficient evidence shows that temperature has an essential link with respiratory infectious diseases. The objectives of this study were to describe the exposure-response relationship between ambient temperature, including extreme temperatures, and mortality of COVID-19.

Methods: The Poisson distributed lag non-linear model (DLNM) was constructed to evaluate the non-linear delayed effects of ambient temperature on death, by using the daily new death of COVID-19 and ambient temperature data from January 10 to March 31, 2020, in Wuhan, China.

Results: During the period mentioned above, the average daily number of COVID-19 deaths was approximately 45.2. Poisson distributed lag non-linear model showed that there was a non-linear relationship (U-shape) between the effect of ambient temperature and mortality. With confounding factors controlled, the daily cumulative relative death risk decreased by 12.3% (95% CI [3.4, 20.4%]) for every 1.0 °C increase in temperature. Moreover, the delayed effects of the low temperature are acute and short-term, with the most considerable risk occurring in 5-7 days of exposure. The delayed effects of the high temperature appeared quickly, then decrease rapidly, and increased sharply 15 days of exposure, mainly manifested as acute and long-term effects. Sensitivity analysis results demonstrated that the results were robust.

Conclusions: The relationship between ambient temperature and COVID-19 mortality was non-linear. There was a negative correlation between the cumulative relative risk of death and temperature. Additionally, exposure to high and low temperatures had divergent impacts on mortality.

Keywords: Ambient temperature; COVID-19; Distributed lag non-linear model; Mortality; Negative correlation.

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Conflict of interest statement

The author declares that he has no competing interests.

Figures

Fig. 1
Fig. 1
Location of Wuhan in Hubei Province, China. The green area indicates the location of Wuhan City, which situated in the east of Hubei Province, People’s Republic of China. The map depicted in Fig. 1 was built in the map software packages in R 3.5.3, which was open access. Additionally, maptools, and mapproj software packages in R 3.5.3 were also used to draw Fig. 1
Fig. 2
Fig. 2
The daily distribution of daily death count and mean temperature in Wuhan from 1 January 2020 to 31 March 2020
Fig. 3
Fig. 3
Temperature-mortality relationships (a) and death cumulative RR for daily mean temperature at lag0–15 days (b)
Fig. 4
Fig. 4
Relative risks of mortality by daily mean temperature along 15 lag days
Fig. 5
Fig. 5
The relative risk of mortality by daily mean temperature at a specific lag day (0, 5, 10, 15 days) and temperatures (− 5.0, 2.0, 10.0, 25.0 °C)
See this image and copyright information in PMC

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