The determinants of COVID-19 morbidity and mortality across countries

Abstract

We identify 21 predetermined country-level factors that explain marked variations in weekly COVID-19 morbidity and mortality across 91 countries between January and the end of 2020. Besides factors commonly associated with infectious diseases (e.g., population and tourism activities), we discover a list of country characteristics that shape COVID-19 outcomes. Among demographic–geographic factors, the male-to-female ratio, population density, and urbanization aggravate the severity of COVID-19, while education, temperature, and religious diversity mitigate the impact of the pandemic on morbidity and mortality. For the political-legal dimension, democracy and political corruption are aggravating factors. In contrast, female leadership, the strength of legal systems, and public trust in government significantly reduce infections and deaths. In terms of socio-economic aspects, GDP per capita, income inequality, and happiness (i.e., life satisfaction) lead to worse COVID-19 outcomes. Interestingly, technology advancement increases morbidity but reduces mortality. For healthcare factors, SARS (severe acute respiratory syndrome) experience and healthcare infrastructure help countries perform better in combating the pandemic.

Mandatory COVID-19 vaccination for healthcare workers: A discussion paper

“…Those who expressed views in favour of mandatory vaccination for HCWs primarily cited ethical and legal rights and duties to protect themselves and the public, justifying the safety profile of the vaccine. There is evidence that COVID-19 is serious, with high morbidity and mortality rates ( Piroth et al, 2021 ; Zylke and Bauchner, 2020 ; Chang et al, 2022 ), notwithstanding the latest reports of long-covid symptoms ( Evans et al, 2022 ; Brown et al, 2022 ). Yet understandably there will be ‘vaccine refusal’ and ‘vaccine hesitancy’ ( Wiysonge et al, 2022 ; Al-Amer et al, 2022 ), a term defined by healthcare professionals, journalists, and policymakers, as the research evidence is limited with this being a relatively new viral infection with novel vaccines ( Karafillakis et al, 2022 ).…”

Association between Fibrinogen-to-Albumin Ratio and Prognosis of Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

“…The global outbreak of the coronavirus disease 2019 (COVID-19) pandemic has already claimed millions of lives since the end of 2019 [ 1 ], and the figure is still on the rise. The clinical manifestations of SARS-CoV-2 infection vary widely, from no apparent symptoms to life-threatening acute respiratory distress syndrome and multiorgan dysfunction [ 2 , 3 , 4 ].…”

Combining and comparing regional SARS-CoV-2 epidemic dynamics in Italy: Bayesian meta-analysis of compartmental models and global sensitivity analysis

“…There are several studies in the literature that have explored the association of socioeconomic, demographic, and health variables with COVID-19-related cases and deaths (50-56). Chang et al (55) analyzed the role of variables measured before the COVID-19 outbreak in explaining the number of confirmed infections and deaths in 91 countries during the second epidemic wave. Similarly to us, they list as "aggravating" factors the level of urbanization, the average age of the population, tourism, and indicators of economic well-being such as GDP; temperature and health infrastructure are listed among the "mitigating" factors, as well as, unlike in our analysis, the level of education of the population.…”