The pandemic has shaken up the rankings of the world's most liveable cities, a study released on Wednesday showed, with metropolises in Australia, Japan and New Zealand leaping ahead of those in Europe.

Auckland tops The Economist's annual survey of the world's most liveable cities in 2021 followed by Osaka and Tokyo in Japan, Adelaide in Australia and Wellington in New Zealand, all of which had a swift response to the Covid pandemic.

"Auckland rose to the top of the ranking owing to its successful approach in containing the Covid-19 pandemic, which allowed its society to remain open and the city to score strongly," the Economist Intelligence Unit said.

In contrast, "European cities fared particularly poorly in this year's edition."

"Vienna, previously the world's most liveable city between 2018-20, fell to 12th. Eight of the top ten biggest falls in the rankings are European cities," according to the study.

The biggest fall overall among the European cities was the port city of Hamburg in northern Germany, which fell 34 places to 47th.

The trend was motivated by a "stress on hospital resources" which the study said increased for most German and French cities and resulted in a "deteriorated healthcare score".

Pressure on European health systems also had a knock-on effect on culture and overall liveability because of restrictions on movement, the Economist said.

The most notable rise was recorded by Honolulu, Hawaii, in the United States, which came 14th in the ranking and moved up 46 places because of its containment of the pandemic and fast vaccination programme.

Damascus remains the city where life is most difficult because of Syria's ongoing civil war.