Association Between Vitamin D Deficiency and COVID-19 Incidence, Complications, and Mortality in 46 Countries: An Ecological Study.

Javier Mariani,Filipe Inserra,Laura Antonietti,León Ferder,Virna Margarita Marín Giménez,Carlos Tajer,Ivana Bergam,Walter Manucha

doi:10.1089/hs.2020.0137

Abstract

Each patient's immune defenses play a major role in mitigating the impact (ie, morbidity and mortality) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19). Vitamin D is an important modulator of the immune system. Although serum 25-hydroxyvitamin D levels can be raised through diet or supplements, most vitamin D in the body is the result of dermal synthesis from ultraviolet radiation. The production of vitamin D in the skin, however, can be limited by latitude, skin-covering clothes, the use of sunblock, and skin pigmentation. Vitamin D deficiency affects a high percentage of the world population. Serum 25-hydroxyvitamin D levels are suboptimal, not only in specific risk groups but also in adults from many countries. Low vitamin D levels, therefore, represent a risk factor for several different pathologies, including SAR-CoV-2. This study used an ecological design to assess the association between vitamin D deficiency and COVID-19 incidence, complications, and mortality across 46 countries. All data were obtained from published sources. The results of the study suggest an association at the population level between the prevalence of vitamin D deficiency and the risk of being infected with COVID-19, severity of the disease, and risk of dying from it.

Highlights

Each patient’s immune defenses play a major role in mitigating the impact of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), the virus responsible for coronavirus disease 2019 (COVID-19).[1]
In Poisson regression models, the association between the positivity ratio and vitamin D deficiency was evident and the relationships were strongest for the second quintile (IRR 2.01; 95% CI, 1.34 to 3.06; P = .001), the fourth quintile (IRR 1.72; 95% CI, 1.15 to 2.62; P < .010) and the fifth quintile (IRR 2.17; 95% CI, 1.48 to 3.26; P < .001) (Figure 2, Table 2)
The results of the present study suggest an association at the population level between the prevalence of vitamin D deficiency and the risk of being infected with COVID-19, severity of the disease, and risk of dying from it

Summary

Introduction

Each patient’s immune defenses play a major role in mitigating the impact (ie, morbidity and mortality) of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), the virus responsible for coronavirus disease 2019 (COVID-19).[1]. MD; and Laura Antonietti, MD; are Clinical Investigators; Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina. Virna Margarita Marın Gimenez, PhD, is an Assistant Professor; Instituto de Investigaciones en Ciencias Quımicas, Facultad de Ciencias Quımicas y Tecnologicas, Universidad Catolica de Cuyo, San Juan, Argentina. Ivana Bergam, PhD, is an Assistant Professor; CROATIA Osiguranje Pension Company for Voluntary Pension Fund Management D.O.O., Zagreb, Croatia. Filipe Inserra, MD, and Leon Ferder, MD, are Clinical Investigators; Universidad Maimonides, Buenos Aires, Argentina. Walter Manucha, PhD, is a Professor Area de Farmacologıa, Departamento de Patologıa, Facultad de Ciencias Medicas, Universidad Nacional de Cuyo, and Director Laboratorio de Farmacologıa Experimental Basica y Traslacional, Instituto de Medicina y Biologıa Experimental de Cuyo, Consejo Nacional de Investigaciones Cientıficas y Tecnologicas; both in Mendoza, Argentina

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