Observational studyInternational journal of biometeorology2022
Heat-related mortality amplified during the COVID-19 pandemic.
Observational study in International journal of biometeorology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 35 citations in OpenAlex.
- Temporal Trends in Mortality in Portugal, 1913-2022.Portuguese journal of public health · 2026Article
- Excess mortality in Europe estimated by EuroMOMO during the COVID-19 pandemic and previous influenza seasons.Nature communications · 2026Article
- The overlapping impacts of heat and COVID-19 on mortality in Flanders, Belgium: a time-stratified case-crossover analysis.Scientific reports · 2025Article
- COVID-19 pandemic as an effect modifier on the association between elevated temperatures and emergency department visits: A case-time-series study in a large population.Environmental epidemiology (Philadelphia, Pa.) · 2025Article
- Secular trends in heat related illness and excess sun exposure rates across climatic zones in the United States from 2017 to 2022.Scientific reports · 2025Article
- Compound mortality impacts from extreme temperatures and the COVID-19 pandemic.Nature communications · 2024Article
- Twenty-first-century demographic and social inequalities of heat-related deaths in Brazilian urban areas.PloS one · 2024Article
- Article
- Analysis of compound health impacts of heatwave and COVID-19 in Korea from May to September in 2020.Scientific reports · 2023Article
- The Intersection of the COVID-19 Pandemic and the 2021 Heat Dome in Canadian Digital News Media: A Content Analysis.International journal of environmental research and public health · 2023Article
- The footprint of human-induced climate change on heat-related deaths in the summer of 2022 in Switzerland.Environmental research letters : ERL [Web site] · 2023Article
- Mortality in Catalonia during the summer of 2022 and its relation with high temperatures and COVID-19 cases.Frontiers in public health · 2023Article
- The Utilization of the WMO-1234 Guidance to Improve Citizen's Wellness and Health: An Italian Perspective.International journal of environmental research and public health · 2022Article
- Impact of the COVID-19 pandemic on changes in temperature-sensitive cardiovascular and respiratory disease mortality in Japan.PloS one · 2022Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
Excess mortality not directly related to the virus has been shown to have increased during the COVID-19 pandemic. However, changes in heat-related mortality during the pandemic have not been addressed in detail. Here, we performed an observational study crossing daily mortality data collected in Portugal (SICO/DGS) with high-resolution temperature series (ERA5/ECMWF), characterizing their relation in the pre-pandemic, and how it aggravated during 2020. The combined result of COVID-19 and extreme temperatures caused the largest annual mortality burden in recent decades (~ 12 000 excess deaths [~ 11% above baseline]). COVID-19 caused the largest fraction of excess mortality during March to May (62%) and from October onwards (85%). During summer, its direct impact was residual, and deaths not reported as COVID-19 dominated excess mortality (553 versus 3 968). A prolonged hot spell led mortality to the upper tertile, reaching its peak in mid-July (+ 45% deaths/day). The lethality ratio (+ 14 deaths per cumulated ºC) was higher than that observed in recent heatwaves. We used a statistical model to estimate expected deaths due to cold/heat, indicating an amplification of at least 50% in heat-related deaths during 2020 compared to pre-pandemic years. Our findings suggest mortality during 2020 has been indirectly amplified by the COVID-19 pandemic, due to the disruption of healthcare systems and fear of population in attending healthcare facilities (expressed in emergency room admissions decreases). While lockdown measures and healthcare systems reorganization prevented deaths directly related to the virus, a significant burden due to other causes represents a strong secondary impact. This was particularly relevant during summer hot spells, when the lethality ratio reached magnitudes not experienced since the 2003 heatwaves. This severe amplification of heat-related mortality during 2020 stresses the need to resume normal healthcare services and public health awareness.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.