COVID-19 mortality increases with northerly latitude after adjustment for age suggesting a link with ultraviolet and vitamin D

• Published in: BMJ nutrition, prevention & health Vol. 3; no. 1; pp. 118 - 120
• Main Authors: Rhodes, Jonathan, Dunstan, Frank, Laird, Eamon, Subramanian, Sreedhar, Kenny, Rose A
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.06.2020; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Air pollution; Coronaviruses; COVID-19; infectious disease; Mortality; nutrient deficiencies; PostScript; United Kingdom > UK; Brazil; United States > US; nutrient deficiencies; infectious disease
• ISSN: 2516-5542; 2516-5542
• DOI: 10.1136/bmjnph-2020-000110

Correspondence to Professor Jonathan Rhodes, Cellular and molecular physiology, University of Liverpool Institute of Translational Medicine, Liverpool L69 3BX, UK; rhodesjm@liverpool.ac.uk Dear Editors, We read with interest the review by Dr Kohlmeier in which he reported a correlation between COVID-19 mortality among African-Americans across the USA and northern latitude.1 We previously reported a north–south gradient in global COVID-19 mortality but were conscious that lack of ultraviolet exposure and consequent vitamin D insufficiency was not the only possible explanation.2 We have now investigated the relationships between latitude, age of population, population density and pollution with COVID-19 mortality. Data by country for population %≥65 years, population density and air pollution (particles of matter <2.5 um diameter µg/m3) were obtained from public sources.4–6 Latitude was entered for each country’s capital city. Table 1 Associations between COVID-19 mortality by country, latitude and % of population ≥65 years Variable Regression coefficient SE P value % of variation explained Effect size (95% CI)* Univariate models   Latitude 0.1074 0.0142 <0.0005 33.1 11.3% (8.3% to 14.5%)   %≥65 0.1766 0.0199 <0.0005 40.4 19.3% (14.8% to 24.1%) Multivariate model   Latitude 0.0428 0.0196 0.031 43.0 4.4% (0.4% to 8.5%)   %≥65 0.1281 0.0291 <0.0005 13.7% (7.4% to 20.3%) *The effect size is, for latitude, the percentage increase in mortality from one location, situated at least 28° north, to another location 1° further north and, for %≥65, the percentage increase in mortality for each one % increase in %≥65.