• Carmen Valero, Raquel Barba, José A Riancho, and Ana Santurtún.
• Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, España. Electronic address: mirvdc@humv.es.
• Med Clin (Barc). 2023 Apr 21; 160 (8): 327332327-332.

ObjectivesEvaluating whether meteorological and geographical variables could be associated with the severity of COVID-19 in Spain.MethodsAn ecological study was performed to analyze the influence of meteorological and geographical factors in hospital admissions and deaths due to COVID-19 in the 52 provinces of Spain (24 coastal and 28 inland regions), during the first three pandemic waves. Medical and mortality data were collected from the CarlosIII Health Institute (ISCIII) and meteorological variables were requested to the Spanish State Meteorological Agency (AEMET).ResultsRegarding the diagnosed cases it is remarkable that the percentage of patients hospitalized for COVID-19 was lower in the coastal provinces than in the inland ones (8.7±2.6% vs. 11.5±2.6%; P=9.9×10-5). Furthermore, coastal regions registered a lower percentage of mortality than inland regions (2.0±0.6% vs. 3.1±0.8%; P=1.7×10-5). Mean air temperature was inversely correlated both with COVID-19 hospitalizations (Rho: -0.59; P=3.0×10-6) and mortality (Rho: -0.70; P=5.3×10-9). In those provinces with a mean air temperature <10°C mortality by COVID-19 was twice that of those with >16°C. Finally, we found an association between mortality and the location of the province (coastal/inland), altitude, patient age and the average air temperature; the latter was inversely and independently correlated with mortality (non-standardized β coeff.: -0.24; 95%CI: -0.31 to -0.16; P=2.38×10-8).ConclusionsThe average air temperature was inversely associated with COVID-19 mortality in our country during the first three waves of the pandemic.Copyright © 2022 Elsevier España, S.L.U. All rights reserved.

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