Worldwide association of lifestyle-related factors and COVID-19 mortality

Jingzhou Wang, Toshiro Sato, Atsushi Sakuraba

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Background: Several lifestyle-related factors, such as obesity and diabetes, have been identified as risk factors for Coronavirus disease 2019 (COVID-19) mortality. The objective of this study was to examine the global association between lifestyle-related factors and COVID-19 mortality using data from each individual country. Methods: The association between prevalence of seven lifestyle-related factors (overweight, insufficient physical activity, smoking, type-2 diabetes, hypertension, hyperlipidaemia, and age over 65) and COVID-19 mortality was assessed by linear and multivariable regression among 186 countries. The cumulative effect of lifestyle-related factors on COVID-19 mortality was assessed by dividing countries into four categories according to the number of lifestyle-related factors in the upper half range and comparing the mean mortality between groups. Results: In linear regression, COVID-19 mortality was significantly associated with overweight, insufficient physical activity, hyperlipidaemia, and age ≥65. In multivariable regression, overweight and age ≥65 demonstrated significant association with COVID-19 mortality (p =.0039,.0094). Countries with more risk factors demonstrated greater COVID-19 mortality (P for trend <.001). Conclusion: Lifestyle-related factors, especially overweight and elderly population, were associated with increased COVID-19 mortality on a global scale. Global effort to reduce burden of lifestyle-related factors along with protection and vaccination of these susceptible groups may help reduce COVID-19 mortality.

Original languageEnglish
Pages (from-to)1528-1533
Number of pages6
JournalAnnals of Medicine
Issue number1
Publication statusPublished - 2021


  • COVID-19
  • diabetes
  • elderly
  • lifestyle-related factors
  • mortality
  • obesity

ASJC Scopus subject areas

  • General Medicine


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