Mean Vitamin D levels in 19 European Countries & COVID-19 Mortality over 10 months
ABSTRACTObjectivesReports early in the epidemic linking low mean national Vitamin D level with increased COVID-19 death, and until recently little research on the impact of Vitamin D deficiency on severity of COVID-19, led to this update of the initial report studying mortality up to the end of January 2021.Methods, Design and SettingCoronavirus pandemic data for 19 European countries were downloaded from Our World in Data, which was last updated on January 24, 2021. Data from March 21, 2020 to January 22, 2021 were included in the statistical analysis. Vitamin-D (25)-HD mean data were collected by literature review. Poisson mixed-effect model was used to model the data.ResultsEuropean countries with Vitamin-D (25)-HD mean less than or equal to 50 have higher COVID-19 death rates as compared with European countries with Vitamin-D (25)-HD mean greater than 50, relative risk of 2.155 (95% CI: 1.068 – 4.347, p-value = 0.032). A statistically significant negative moderate Spearman rank correlation was observed between Vitamin-D (25)-HD mean and the number of COVID-19 deaths for each 14-day period during the COVID-19 pandemic time period.ConclusionsThe observation of the significantly lower COVID-19 mortality rates in countries with lowest annual sun exposure but highest mean Vitamin-D (25)-HD levels provides support for more awareness and possible use of food fortification. The need to consider re-configuring vaccine strategy due to emergence of large number of COVID-19 variants and studies identifying poor responders to Vaccine provides an opportunity to undertake therapeutic randomized control trials to confirm these observations.Strengths of this studyLarge number of different European populations studied with different policies of food fortification and different population Vitamin D levelsTen months of longitudinal study during rise and fall and rise again of the epidemicLimitations of this studyBased on population Vitamin D levels published before the beginning of the pandemic. Though there hasn’t been a pan-European national/international health education initiative about Vitamin D and COVID-19 infection, it has been well covered in the media and could have resulted in changes, though probably minor, at the national level. Because there have been many differences in response to the pandemic in these countries, there could be other factors involved as well