COVID-19 Mortality in Europe, by Latitude and Obesity Status: A Geo-Spatial Analysis in 40 Countries

Background: On January 30, 2020, the World Health Organization (WHO) declared the COVID-19 as a public health emergency of international concern and later characterized it as a pandemic. Based on new data, excess body mass and vitamin D deficiency might be related with the disease severity and mortality. Thus, we aimed to evaluate whether latitude, as a proxy of sunlight exposure and Vitamin D synthesis, and prevalent obesity among European populations, is related with COVID-19 spread and severity. Methods: European COVID-19 data (incidence and fatality), including information on the prevalence of obesity, social distancing and others were obtained by the “Our World in Data” website on April 17, 2021.Findings : Adjusted analysis showed that higher COVID-19 incidence and fatality were pictured in countries being in higher latitude, both during the whole period [IRR (95% CI): Incidence= 1·07047 (1·07041, 1·07054), Fatality= 1·08650 (1·08605, 1·08695)], as well as, during the time period 1/11/2020-31/3/2021 [IRR (95% CI): Incidence= 1·07571 (1·07563, 1·07579), Fatality= 1·09202 (1·09145, 1·09258)]. Higher incidence and fatality of COVID-19 were observed where the prevalence of overweight/ obesity was higher during the whole time period [IRR (95% CI): Incidence= 1·01463 (1·01251, 1·01681), Fatality= 1·03000 (1·01438, 1·04587)], whereas during the time period 1/11/2020-31/3/2021, only COVID-19 incidence was higher but not fatality.Interpretation: Excess body mass and high latitude were found to be related with COVID-19 spread and mortality across Europe. These results provide insights for targeted interventions and preventive strategies against COVID-19.Funding: The authors received no specific funding for this work.Declaration of Interest: Declaration of interests: No conflict of interest