The Association of Country-Level Factors with Outcomes of COVID-19: Analysis of the pandemic after one million cases

Abstract Background: Coronavirus infectious disease 2019 (COVID-19) is an ongoing global pandemic. Without a vaccine or an effective treatment in the near horizon, only public health measures have been effective in potentially reducing its impact. Due to the wide disparity in current response from individual countries, studying factors associated with public health measures may inform ongoing efforts. Therefore, this study aims to analyze the contributing factors across the globe with specific measures of the disease. Methods: This is a cross-sectional study that used publicly available data of COVID-19 cases as of April 6, 2020. We analyzed country public information on demographic and socioeconomic indicators published in different sources. The association between country-level variables and the incidence rate, the recovery rate, severity of the cases, and mortality rate were evaluated using regression techniques. Results: Multiple factors were found to be significantly associated with COVID-19 outcomes. The number of tests per million, GDP per capita, a country population size of 2020, country median age, and life expectancy are associated with the incidence rate of COVID19. The yearly net change population, migrants, and tourism are associated with the recovery rate of COVID-19. The number of tests per million and male life expectancy are associated with the critical cases rate of COVID-19. Finally, the GDP per capita, land area (Km2), life expectancy, and tourism are associated with the mortality rate of COVID-19. Conclusion: Overall, higher GDP per capita, median age, and a higher number of lab tests were found to be associated with more incidents of COVID-19 cases, which indicates a better and maintained system for detection, reporting, and management of the pandemic. This study suggests that investing in better screening and testing may reveal more cases that can be managed and controlled; while limiting travelers would further support the pandemic control.