A new study revealed Thursday that support for Brazil's pandemic-skeptic President Jair Bolsonaro is linked to higher COVID-19 death rates, showing that counties that voted for Bolsonaro had substantially higher death rates than those that did not.

The study, which compared voting results in Brazil's 2018 presidential election in the southeastern state of Minas Gerais with county-level COVID-19 infection and mortality rates, found the disease hit harder in areas that voted for the far-right president, who has regularly clashed with expert advice on fighting the pandemic.

"Bolsonaro has denied COVID-19 severity, promoted treatments without evidence of efficacy, and discouraged social distancing, the use of masks, local lockdowns and other protective measures," said co-author Carlos Starling of the Minas Gerais Society of Infectious Disease Specialists.

That "has likely resulted in higher infection rates and deaths from COVID-19 among his supporters," he added in a statement.

The study, which analyzed data from Jan. 21 to Nov. 10 last year, found infection rates were 30% higher in counties where then-candidate Bolsonaro won in 2018 – 7,600 per 100,000 inhabitants, on average. Death rates were 60% higher there, it found – 212 per 100,000, on average.

COVID-19 has claimed more than 660,000 lives in Brazil, second only to the United States in absolute numbers.

However, the weekly death toll has fallen dramatically with 75% of Brazil's 213 million people now fully vaccinated – despite repeated anti-vaccine comments from Bolsonaro.

Starling and bioinformatics expert Braulio Couto will present the still-unpublished study this month at the European Congress of Clinical Microbiology and Infectious Diseases in Lisbon, whose selection committee peer-reviewed their findings.

It echoed the results of a similar study published in March in the medical journal, The Lancet, which compared Brazil's 2018 election results nationwide with COVID-19 death rates and also found counties that voted for Bolsonaro fared worse in the pandemic.

Bolsonaro, who comes up for reelection in October, has faced damaging criticism over his handling of the virus he dismissed as a "little flu." A Senate commission last October recommended he face criminal charges, including crimes against humanity, for his response to the pandemic.

The government did not immediately respond to a request for comment on the study.