OBJECTIVES : The occurrence of coronavirus disease 2019 (COVID-19) showed different patterns in different countries. The aim of our study is to analyse the geographical inequalities in the occurrence of COVID-19 caused by SARS-CoV-2 virus in member states of the European Union (EU).

METHODS : Data derived from the European Centre for Disease Prevention and Control (ECDC) of European Union. Member states of the European Union were classified according to their geographical location: Western-European (Austria, Belgium, France, Germany, Luxembourg, Netherlands), Eastern-European (Bulgaria, Croatia, Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia, Slovenia), Mediterranean (Cyprus, Greece, Italy, Malta, Portugal, Spain) and Nordic (Denmark, Finland, Ireland, Sweden) countries. Total number of COVID-19 cases per 1 million population and standard deviation (SD) was calculated with weighted averages. Period up to 7 July 2020 was covered. Single factor analysis of variance (ANOVA) was performed.

RESULTS : Up to 07.07.2020 in the European Union 1,313,317 COVID-19 cases were identified resulting in an incidence of 2.950 cases/1 million population. We found the highest occurrence in Luxembourg (7,352 cases/1 million population), Sweden (7,262), Spain (6,400), Belgium (5,354), Ireland (5,171), while the lowest occurrence was observed in Lithuania (678), Latvia (601), Hungary (435), Greece (344), Slovakia (324). We found 19.8-fold differences in the incidence of COVID-19 cases among EU countries with the lowest (Slovakia: 324) and highest (Luxembourg: 7,352) occurrence. Mediterranean countries had the highest incidence 4,563 (SD:+/-2,378), followed by Nordic: 4,514 (SD:+/-2,732), Western-European: 2.683 (SD:+/-2,114) and Eastern-European: 986 (SD:+/-395) countries. The relative risk of COVID-19 occurrence was 4.63-times higher in Mediterranean, 4.58-times higher in Nordic and 2.72-times higher in Western-European countries compared to Eastern-European countries. Single factor analysis of variance (ANOVA) showed significant differences among country groups (P<0.008).

CONCLUSIONS : Eastern-European countries had significantly lower incidence of COVID-19 cases compared to Western-European, Mediterranean and Nordic countries in the European Union.