Epidemiological Characteristics of COVID-19 Deaths in China: An Analysis of Environmental Factors

Abstract Background Since December 2019, China has carried out dramatic containment measures to control the spread of COVID-19. As of April 6, 2020, most of the confirmed cases outside Hubei province have been cured or confirmed dead. In this study, we aimed to understand environmental factors leading to COVID-19-related mortality outside of Hubei province, in mainland China. Methods We collected spatial-temporal and environmental data of 99 cases of COVID-19-related deaths outside of Hubei province in Mainland China between January 22, 2020 and April 6, 2020. A descriptive analysis, including a spatial-temporal distribution of daily reported diagnosed cases and related deaths, was conducted. We analyzed the possible environmental factors that affect the provincial-level CFR of COVID-19 outside Hubei, China. Results Among the 99 reported deaths, 59 (59.6%) were male and 40 (40.4%) were female. The mean age at death was 71.30 (SD 12.98) years and 74 deaths were among those 65 years or older. The CFR was negatively correlated with temperature (r=-0.679, P < 0.001) and humidity (r=-0.607, P = 0.002), while latitude was positively correlated with the CFR (r = 0.636, P = 0.001). There were no statistically significant associations between CFR and the social environment factors. Conclusion Higher CFR of COVID-19 was associated with lower temperature, lower humidity, and higher latitude. Continual analysis of daily reported diagnoses and mortality data can help healthcare professionals and policy makers understand the trends within a country in order to better prepare nationwide prevention and care guidelines, along with adequately appropriate funds accordingly.