A cluster analysis of epidemiological and clinical factors associated with the accumulation process of the burden of COVID-19 in European countries

Background and aim of the work: European COVID-19 statistics showed differentiation between mortality and new cases. Some studies suggested several factors including migration, cancer incidence, life expectancy and health system capacity maybe associated with differentiations. Up to now, impact of those fac-tors in different European societies is not discussed and compared. Aim of the present study was to perform the cluster analysis in European countries in attention to clinical and epidemiological factors due to covid-19. Methods:We collected some appropriate extreme data of COVID-19 to access the situations by ANOVA post-hoc test in 3 scenarios, as well as to estimate regression coefficients in simple linear regression, and a cluster analysis using average linkage. The present study was designed to assess the situation in the European region in the face of COVID-19 from the beginning of the conflict to April 24, 2020. Results:Among 39 European countries, several countries reported highest rate of confirmed cases included of Italy (current stat-ues=2270.52) and Spain (current status=2616.24). The highest rate of mortality was seen in France (current status=242.16), Italy (current status=305.52). Life expectancy (female) (P=0.01, 95%Cl=1521.27,15264.58), migration (P<0.001, 95%Cl=41.42,96.72) had significant association with confirmed cases and death. Over-all cancer death (P<0.001, 95%Cl=0.36,0.68; P<0.001, 95%Cl=0.01,0.07) and lung cancer death (P<0.001, 95%Cl=1.97,3.56; P<0.001, 95%Cl=0.09,0.37) associated with confirmed cases and mortality, too. We were also determined 5 clusters which more than 30 countries were categorized in the first cluster. Conclusions: Demographic factors, including population, life expectancy and migration, underlying disorders, such as sev-eral types of cancers, especially lung cancers lead to various distribution of COVID-19 in terms of prevalence and mortality, across European counties.