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Journal of Exposure Science & Environmental Epidemiology

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Background: The associations between meteorological factors and coronavirus disease 2019 (COVID-19) have been discussed globally; however, because of short study periods, the lack of considering lagged effects, and different study areas, results from the literature were diverse and even contradictory. Objective: The primary purpose of this study is to conduct more reliable research to evaluate the lagged meteorological impacts on COVID-19 incidence by considering a relatively long study period and diversified high-risk areas in the United States. Methods: This study adopted the distributed lagged nonlinear model with a spatial function to analyze COVID-19 incidence predicted by multiple meteorological measures from March to October of 2020 across 203 high-risk counties in the United States. The estimated spatial function was further smoothed within the entire continental United States by the biharmonic spline interpolation. Results: Our findings suggest that the maximum temperature, minimum relative humidity, and precipitation were the best meteorological predictors. Most significantly positive associations were found from 3 to 11 lagged days in lower levels of each selected meteorological factor. In particular, a significantly positive association appeared in minimum relative humidity higher than 88.36% at 5-day lag. The spatial analysis also shows excessive risks in the north-central United States. Significance: The research findings can contribute to the implementation of early warning surveillance of COVID-19 by using weather forecasting for up to two weeks in high-risk counties.


COVID-19; Temperature; Relative humidity; Precipitation; Lag; Spatial


Clinical Epidemiology | Virus Diseases

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