To analyze the global epidemic characteristics and influencing factors of coronavirus disease 2019 (COVID-19) from 2020-2022 and discuss the epidemiological partens of the disease, so as to provide reference for and formulation of prevention and control strategy.

The data of COVID-19 epidemics, demography, economy, health status were collected. Descriptive epidemiology and negative binomial regression methods were used to analyze the epidemiological characteristics and influencing factors.

By the end of December 31, 2022, the average incidence and mortality rate over the past 3 years were 27.95‰ and 28.44/100 000, respectively with the case fatality rate of 1.02%. During 2020-2022, the incidences of COVID-19 increased sequentially (10.67‰, 26.04‰, 46.98‰), the mortality increased first and then decreased (24.82/100 000, 44.90/100 000, 15.56/100 000). The case fatality rate showed a downward trend (2.33%, 1.72%, 0.33%). There was no obvious seasonality in reported confirmed and death cases each year. The cumulative incidence and mortality in America and Europe were significantly higher than those in other regions. Africa had the highest case fatality rate. The cumulative incidence and mortality of high-income countries and upper middle-income countries were higher than those of low-income countries and lower middle-income countries. The cumulative case fatality rate was the highest in low-income countries. After vaccination, except for continuously increasement in the incidence, other criteria, including mortality and case fatality rate declined. The negative binomial regression analysis in 2020 showed that higher percentage of health expenditure in GDP and higher life expectancy at birth related to higher number of confirmed case of COVID-19.

From 2020 to 2022, COVID-19 maintained high levels of prevalence with declined mortality and case fatality rate as well as less impact on populational health. The difference in prevalence levels of COVID-19 in countries with different economic levels was obvious. International co-operation could be an effective route to improve the epidemic prevention capacity among countries.

Coronavirus disease 2019; Epidemiological characteristics; Influencing factors; Negative binomial regression