Association between temperature and COVID-19 transmission in 153 countries

The WHO characterized coronavirus disease 2019 (COVID-19) as a global pandemic. The influence of temperature on COVID-19 remains unclear. The objective of this study was to investigate the correlation between temperature and daily newly confirmed COVID-19 cases by different climate regions and temperature levels worldwide. Daily data on average temperature (AT), maximum temperature (MAXT), minimum temperature (MINT), and new COVID-19 cases were collected from 153 countries and 31 provinces of mainland China. We used the spline function method to preliminarily explore the relationship between R₀ and temperature. The generalized additive model (GAM) was used to analyze the association between temperature and daily new cases of COVID-19, and a random effects meta-analysis was conducted to calculate the pooled results in different regions in the second stage. Our findings revealed that temperature was positively related to daily new cases at low temperature but negatively related to daily new cases at high temperature. When the temperature was below the smoothing plot peak, in the temperate zone or at a low temperature level (e.g., <25th percentiles), the RRs were 1.09 (95% CI: 1.04, 1.15), 1.10 (95% CI: 1.05, 1.15), and 1.14 (95% CI: 1.06, 1.23) associated with a 1°C increase in AT, respectively. Whereas temperature was above the smoothing plot peak, in a tropical zone or at a high temperature level (e.g., >75th percentiles), the RRs were 0.79 (95% CI: 0.68, 0.93), 0.60 (95% CI: 0.43, 0.83), and 0.48 (95% CI: 0.28, 0.81) associated with a 1°C increase in AT, respectively. The results were confirmed to be similar regarding MINT, MAXT, and sensitivity analysis. These findings provide preliminary evidence for the prevention and control of COVID-19 in different regions and temperature levels.