Mean Vitamin D levels in 19 European Countries & COVID-19 Mortality over 10 months

Objectives: Reports 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 the severity of COVID 19, led to this update of the initial report studying mortality up to the end of January 2021. Methods, Design and Setting: Coronavirus 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 means data were collected by literature review. Poisson mixed-effect model was used to model the data. Results: European 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, the 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. Conclusions: The observation of the significantly lower COVID 19 mortality rates in countries with the lowest annual sun exposure but the 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 the emergence of a 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.