The study provides substantial new data on the direct as well as indirect impacts of the COVID-19 pandemic, thermal comfort and heat-related illness, in Jakarta, Hyderabad, Karachi and Hyderabad and Douala. These cities are home to very large or rapidly growing low-income populations dealing with extreme heat. Alongside data on heat exposure and symptoms associated with heat-related illness, the report supplies supplementary data points on access to electricity, water, food, health services, as well as income and food intake during the COVID-19 pandemic, that will be of use to policy makers and researchers. The report is intended for use by governmental and non-governmental organisations in these cities and countries as they work to fine-tune policy and programme responses to the COVID-19 pandemic and avoid heat-related health impacts. Its broader findings are intended to be of use to inform interventions in urban areas facing similar challenges across Sub-Saharan Africa, South Asia and South East Asia.