Association between Average Vitamin D Levels and COVID-19 Mortality in 19 European Countries—A Population-Based Study

• Published in: Nutrients Vol. 15; no. 22; p. 4818
• Main Authors: Ahmad, Amar S, Juber, Nirmin F, Al-Naseri, Heba, Heumann, Christian, Ali, Raghib, Oliver, Tim
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.11.2023
• Subjects: Alfacalcidol; Calcifediol; Clinical outcomes; coronavirus; COVID-19; Disease transmission; Europe; Infections; Infectious diseases; Mortality; Multivariate analysis; Pandemics; population-based study; Public health; Rankings; Statistical analysis; United Kingdom; Variables; Vitamin D; Vitamin deficiency; United Kingdom; Greece; United Kingdom > UK
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu15224818

Early epidemic reports have linked low average 25(OH) vitamin D levels with increased COVID-19 mortality. However, there has been limited updated research on 25(OH) vitamin D and its impact on COVID-19 mortality. This study aimed to update the initial report studying the link between vitamin D deficiency and COVID-19 mortality by using multi-country data in 19 European countries up to the middle of June 2023. COVID-19 data for 19 European countries included in this study were downloaded from Our World in Data from 1 March 2020, to 14 June 2023, and were included in the statistical analysis. The 25(OH) vitamin D average data were collected by conducting a literature review. A generalized estimation equation model was used to model the data. Compared to European countries with 25(OH) vitamin D levels of ≤50 nmol/L, European countries with 25(OH) vitamin D average levels greater than 50 nmol/L had lower COVID-19 mortality rates (RR = 0.794, 95% CI: 0.662–0.953). A statistically significant negative Spearman rank correlation was observed between 25(OH) vitamin D average levels and COVID-19 mortality. We also found significantly lower COVID-19 mortality rates in countries with high average 25(OH) vitamin D levels. Randomized trials on vitamin D supplementation are needed. In the meantime, the issue of vitamin D use should be debated in relation to the ongoing discussions of national post-COVID-19 resilience against future pandemics.